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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2014

Open Access 01-12-2014 | Research article

Effects of stemmed and nonstemmed hip replacement on stress distribution of proximal femur and implant

Authors: Chun-Ming Chen, Wen-Chi Tsai, Shang-Chih Lin, Ching-Shiow Tseng

Published in: BMC Musculoskeletal Disorders | Issue 1/2014

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Abstract

Background

Despite improvements in shape, material, and coating for hip stem, both stress shielding and aseptic loosening have been the major drawbacks of stemmed hip arthroplasty. Some nonstemmed systems were developed to avoid rasping off the intramedullary canal and evacuating the bone marrow due to stem insertion.

Methods

In this study, the finite-element models of one intact, one stemmed, and two nonstemmed femora with minimal removal of the healthy neck were investigated to evaluate their biomechanical effects. The resurfacing (ball-shaped) and fitting (neck-shaped) systems were respectively selected as the representative of the ready- and custom-made nonstemmed implants. The stress distribution and interface micromotion were selected as the comparison indices.

Results

The results showed that stress distributions of the two nonstemmed femora are consistently more similar to the intact femur than the stemmed one. Around the proximal femur, the stem definitely induces the stress-shielding phenomenon of its counterparts. The fitting system with the anatomy-shaped cup can make intimate contact with the neck cortex and reduce the bone-cup micromotion and the implant stress. Comparatively, the reamed femoral head provides weaker support to the resurfacing cup causing higher interfacial micromotion.

Conclusions

The reserved femoral neck could act as the load-transferring medium from the acetabular cup, femoral neck, to the diaphysial bone, thus depressing the stress-shielding effect below the neck region. If the hip-cup construct can be definitely stabilized, the nonstemmed design could be an alternative of hip arthroplasty for the younger or the specific patients with the disease limited only to the femoral head.
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Metadata
Title
Effects of stemmed and nonstemmed hip replacement on stress distribution of proximal femur and implant
Authors
Chun-Ming Chen
Wen-Chi Tsai
Shang-Chih Lin
Ching-Shiow Tseng
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2014
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-15-312

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