Effects of Dall-Miles Cables on the Cement Mantle in Total Hip Arthroplasty: A Cadaveric Study

Dall-Miles cables are widely used for trochanteric re-attachment in hip arthroplasty, but their effects on the cement mantle have not been reported. We have carried out an ex vivo study to investigate the influence of cables on the mantle. Charnley femoral components were implanted in eight proximal human femora using Palacos cement. Wires (control group, n=4) or 2mm stainless steel Dall-Miles cables (n=4) were passed through holes drilled in the proximal femur before the cement was introduced. The wires or cables were tightened using the appropriate instruments after the cement had hardened. The specimens were sectioned using a diamond saw, and examined by scanning electron microscopy and light microscopy before and after staining with penetrant dye. Deformation of the strands at the tension edge of each cable, with debonding from the cement in two specimens, was observed. There was no damage to cement at the compression edge. Tensioning of Dall-Miles cables passing through Palacos cement does not appear to damage the mantle.