Fixation of Revision Implants Is Improved by the Surgical Technique of Cracking the Sclerotic Bone Rim Compared to Reaming

CRACKING THE SCLEROTIC BONE RIM COMPARED TO REAMING +*Elmengaard, B; **Bechtold, JE; *Baas, J; Jakobsen, T; *Søballe, K +*Department of Orthopaedic Surgery, University of Aarhus, Denmark [email protected] INTRODUCTION Revision hip replacement implants have poorer clinical outcome than primary implants. The fixation of the implants is often compromised by the formation of an endosteal sclerotic bone rim during the process of aseptic loosening. The cracking procedure is a bone sparing, low energy surgical technique which produces a controlled local perforation of the sclerotic bone rim. In previous studies, we showed that fixation of revision implants significantly improved by the cracking technique for both titanium (Ti) and hydroxyapatite (HA) coated implants with and without the use of bone graft(1). In this study we compared the cracking technique with the common technique of reaming, which completely removes the sclerotic bone rim. We hypothesized that the crack revision procedure would result in superior mechanical fixation of titanium implants compared to those inserted with the reaming procedure.