Introduction: Various plating devices and screw systems are available for single and multi-level cervical fusions. Recent reports regarding screw migration under torsional load and a “windshield wiper effect” has brought to light the importance of plate and screw design as well as the choice of graft.

Aim: This study examined the relative stability of cervical plating systems under pure bending and axial-torsional fatigue using the Cloward type graft.

Methods: Five fresh-frozen human cervical and 10 porcine spines assessed by dual-energy x-ray absorptiometry (DEXA) scanning and then reconstructed at the C_2–3 and levels using the anterior Cloward technique. C_4–5 Two different plating systems (a solid plate and a hollow plate) were used and alternated between the C2–3 and C4–5 levels. Strain gauges placed on the plates themselves. The systems were subjected to pure bending and torsional loading.. Five kilogram loads were used to apply bending moments to the spine and did not differ between the two systems evaluated. Bending moments and displacement angles were recorded for the pure bending loading regime and torque versus time was recorded for the torsional fatigue loading.

Results: Strain gauge analysis revealed minimal strains on the plates under the loading conditions. Torque versus time was measured, and the decay constant was calculated from the decay curves. The hollow plating system decayed quicker than the solid plating system. Angular displacement under pure bending was minimal. The hollow system plate system resisted greater torque compared with the solid system. The decay curves eventually reached an asymptote for the both systems. This implied that the systems become stable under fatigue loading. The X-rays illustrated no failure at the screw/ bone interface (i.e. No “wiper” effect) after torsional fatigue.

Introduction: Proximal bone resorption is a common problem after total hip arthroplasty. This has been attributed to stress shielding and has been reported to be more pronounced for cemented than for uncemented implants.

Aim: To investigate the cortical strain distribution of a new proximal “fit and fill” cementless, titanium, femoral, hip prosthesis based on the SROM design.

Methods: Strain gauges were mounted on five fresh-frozen cadaveric and five saw-bone femora and checked against a template for the prosthesis. The strain gauges were placed at four levels on the anterior, posterior, medial and lateral cortices corresponding to the Gruen zones. Two extra strain gauges were placed on the proximal posteromedial cortex. Loading was applied to the intact and reconstructed femora in the ISO 7206–4 orientation and single legged stance in an MTS servo-hydraulic testing machine. Data were analysed using analysis of variance.

Results: The strain distributions following reconstruction and multi-axis loading (ISO 7206–4 orientation) approximated the strains in an intact femur in the diaphysis. The proximal posteromedial cortical strains were approximately 50% of those of the intact femur.

Conclusions: The strains observed in the proximal femur following reconstruction in the present study are considerably higher than most others reported in the literature. A number of factors may contribute to the high proximal strains observed. This study has illustrated that geometric design and material selection along with surgical technique may allow for greater loading to proximal bone and enhance the long term integrity of this type of implant.