Changes in Femoral Cortical Porosity After Reaming and Intramedullary Canal Preparation in a Canine Model

This study examined changes in femoral cortical porosity resulting from femoral canal preparation during cemented total hip arthroplasty (THA). Twenty-four canines were randomly assigned to 3 groups: (1) reaming only, (2) cementing without pressurization, and (3) cementing with pressurization. Femoral cortical porosity was measured from histologic samples of the femurs at 7 positions. Reaming during canal preparation significantly increased cortical porosity. Cementing further increased cortical porosity, whereas pressurization of cement helped to counteract the increase in cortical porosity caused by cementing alone. Cortical porosity was considered to be a marker for bone mineral density (BMD) during the early phase of peri-implant healing around cemented stems. To maximize bone mineral density after cemented total hip arthroplasty, we suggest using implants that do not require reaming and pressurizing cement appropriately.