Biomechanical Analysis of the French Paradox and Standard Cementing Techniques for Femoral Stems in Hip Arthroplasty

Total hip arthroplasty (THA) is one of the most successful procedures in modern medicine. As the population ages, the number of THAs performed increases as well. With age comes a decrease in bone quality. Cemented femoral stems are known to provide an advantage in older patients. However, there is debate regarding the optimal technique for cementing femoral stems. In this thesis, we compared the line-to-line cementing technique, also known as the “French Paradox” (FP), with the standard (STD) cementing technique involving a minimum 2 mm cement mantle via a cadaver-based biomechanical model. The relationship between these varying techniques, cement mantle thickness, alignment of the stem and micromotion were examined. Results demonstrate that both techniques appear to result in well-fixed and well-aligned stems with no statistically significant difference in micromotion or alignment. Cement mantle thickness was, as expected, thinner in the FP technique. Further longer-term clinical studies are necessary to determine whether the differences noted are of any clinical significance.