The shear strength of trabecular bone from the femur has been studied. In general, the strongest trabecular bone is found close to the cortico-cancellous junction, though its shear strength depends also on the relationship of the trabeculae to the plane of shear. Some factors affecting the shear strength of the cement-bone interface have been investigated. In vitro, maximal cement-bone interface shear strength is obtained by exposing and thoroughly cleaning strong trabecular bone, and then forcing onto it under pressure low viscosity cement.
We present two cases of infected primary total hip replacements (THR) where only one of the two components exhibited loosening. Both were revised using a two stage, one component revision technique, replacing the loose component only. In the first case the acetabular component was revised leaving the original femoral stem in situ. In the second case, the femoral component was revised, leaving the original acetabular cup undisturbed. Both patients remained infection free at three and half and three years follow up respectively.
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