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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v16.i6.10
pages 407-422

Surface Finish Mechanics Explain Different Clinical Survivorship of Cemented Femoral Stems for Total Hip Arthroplasty

Burak Beksac
Hospital for Special Surgery, Weill Medical College of Cornell University, New York
Nicole A. Taveras
Hospital for Special Surgery, Weill Medical College of Cornell University, New York
Alejandro Gonzalez Della Valle
Orthopaedic Fellow at The Hospital for Special Surgery, New York, New York; and Senior Clinical Associate in Orthopaedic Surgery at Weill Medical College of Cornell University, New York
Eduardo A. Salvati
Clinical Professor Orthopaedic Surgery; Director of Hip & Knee Service. Hospital for Special Surgery Weill Medical College of Cornell University 535 East 70th Street New York NY 10021

ABSTRACT

The ability of bone cement to adhere to the implant surface is dependent on the surface finish. Stems with a rough surface finish require greater force to disrupt their interface with the cement than do stems with a smooth or polished surface. However, if micromotion occurs at the cement-metal interface, the fretting of a smoother surface implant results in less cement and metallic abrasion than an implant with a rough surface finish. Today, surgeons implant femoral stems with a wide variety of surface finish and textures that are supported by the previously mentioned contrasting philosophy of fixation. This article presents the micro and macro surface finish mechanics, history, and rationale for changes in surface finish, the clinical and operative implications of changes in surface finish, the retrieval analysis, and the clinical evidence that examine the consequences of changes in surface finish in the outcome of cemented femoral stems for total hip arthroplasty. Current data and our own experience support the use of cemented femoral stems with a smooth or polished surface finish.