ArticleArthroplasty today2022
Variability in Femoral Preparation and Implantation Between Surgeons Using Manual and Powered Impaction in Total Hip Arthroplasty.
Article in Arthroplasty today, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Automated impaction in uncemented total hip arthroplasty : a systematic review and meta-analysis.Bone & joint open · 2026Pooled it
- Early Performance of a Collared, Triple-Tapered Cementless Femoral Stem in Primary Total Hip Arthroplasty.Journal of clinical medicine · 2026Article
- Automated Impaction Improves Femoral Component Canal Fit in Total Hip Arthroplasty: A Matched Study.Arthroplasty today · 2025Article
- Low risk of periprosthetic fracture and subsidence with automated impaction device in arthroplasty following femoral neck fracture: A retrospective study.Journal of orthopaedics · 2025Article
- Fracture of the Femoral Broach Locking Mechanism and Surgical Technique to Retrieve the Broach.Arthroplasty today · 2025Article
- Mitigating calcar fracture risk with automated impaction during total hip arthroplasty.Journal of orthopaedics · 2025Article
- Small design modifications can improve the primary stability of a fully coated tapered wedge hip stem.PloS one · 2024Article
- Biomechanical Comparison of Impaction Techniques and Cross-Sectional Femoral Stem Shapes for Cementless Total Hip Arthroplasty.Kansas journal of medicine · 2024Article
- Does Powered Femoral Broaching Compromise Patient Safety in Total Hip Arthroplasty?Arthroplasty today · 2023Article
- A parametric numerical analysis of femoral stem impaction.PloS one · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe influence of the surgical process on implant loosening and periprosthetic fractures (PPF) as major complications in uncemented total hip arthroplasty (THA) has rarely been studied because of the difficulty in quantification. Meanwhile, registry analyses have clearly shown a decrease in complications with increasing experience. The goal of this study was to determine the extent of variability in THA stem implantation between highly experienced surgeons with respect to implant size, position, press-fit, contact area, primary stability, and the effect of using a powered impaction tool.
methodsPrimary hip stems were implanted in 16 cadaveric femur pairs by three experienced surgeons using manual and powered impaction. Quantitative CTs were taken before and after each process step, and stem tilt, canal-fill-ratio, press-fit, and contact determined. Eleven femur pairs were additionally tested for primary stability under cyclic loading conditions.
resultsManual impactions led to higher variations in press-fit and contact area between the surgeons than powered impactions. Stem tilt and implant sizing varied between surgeons but not between impaction methods. Larger stems exhibited less micromotion than smaller stems.
conclusionsLarger implants may increase PPF risk, while smaller implants reduce primary stability. The reduced variation for powered impactions indicates that appropriate measures may promote a more standardized process. The variations between these experienced surgeons may represent an acceptable range for this specific stem design. Variability in the implantation process warrants further investigations since certain deviations, for example, a stem tilt toward varus, might increase bone stresses and PPF risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.