Effectiveness of prophylactic double-looped wiring in cementless Hip arthroplasty: A biomechanical study in osteoporotic bone model using impaction simulation system

•Prophylactic double-looped cerclage wiring (PDLCW) on the femoral neck can decrease the risk of calcar fracture during cementless hip arthroplasty (HA) in osteoporotic patients. Therefore, PDLCW should be considered in the patients undergoing cementless HA with high risk for calcar fracture such as those with radiographic evidence of poor bone quality.•The recommended PDLCW surgical technique and instrument is using 1.5-mm cerclage wire applied, in double-looped fashion, adjacent to the superior aspect of the lesser trochanter at the angle perpendicular to the calcar axis.•Double-looped cerclage wiring application after visible calcar crack still has significantly lower efficacy of hoop stress resistance compared to the control group but is helpful for prevention of the complete calcar fracture and stem subsidence.