Purpose: Implant loosening is a common complication that compromises the stability of joint replacement systems. Stem geometry is particularly influential in the stability of cemented implants, both before and after debonding occurs at the stem-cement interface. There are few studies assessing the effect of stem longitudinal curvature as a geometric factor in cemented implant stability. The purpose of this study was to compare the torsional stability of four generalized cemented implant stems (i.e., non-specific to joint), with varying degrees of longitudinal curvatures--zero, two, four, and six degrees.
Methods: Twelve specimens of each curvature angle were potted to a depth of 20 mm using bone cement, given 24 hours to cure, and then tested in a materials testing machine. Torque was applied to the stems under monotonic loading at a rate of 2.5 degrees/min, until five degrees of rotation had occurred.
Results: There were no differences in torsional stability among the four stem curvature angles, when the magnitudes of peak torque (P=.72; 1-β = 0.13), rotation of the stem at peak torque (P=0.23; 1-β = 0.38) and work required for five degrees of stem rotation (P=.58; 1-β = 0.07) were compared.
Conclusions: The findings from this study demonstrate that for short stems, stem curvature angles up to six degrees does not improve torsional stability when compared to the straight stem design.