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Open Access 01-12-2023 | Hip-TEP | Research

TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems

Authors: Kazuyoshi Baba, Yu Mori, Daisuke Chiba, Yoshiyuki Kuwahara, Hiroaki Kurishima, Hidetatsu Tanaka, Atsushi Kogure, Masayuki Kamimura, Norikazu Yamada, Susumu Ohtsu, Masamizu Oyama, Naoya Masahashi, Shuji Hanada, Eiji Itoi, Toshimi Aizawa

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Background

The difference between Young’s moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young’s modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems.

Methods

This study was a clinical trial. Primary THA was performed using a TNS stem from April 2016 to September 2017 for patients in the TNS group. Unilateral THA was performed using a Ti6Al4V alloy stem from January 2007 to February 2011 for patients in the control group. The TNS and Ti6Al4V stems were matched in shape. Radiographs were obtained at the 1- and 3-year follow-ups. Two surgeons independently checked the SS grade and appearance of cortical hypertrophy (CH). The Japanese Orthopaedic Association (JOA) scores before and 1 year after surgery were assessed as clinical scores.

Results

None of the patients in the TNS group had grade 3 or 4 SS. In contrast, in the control group, 24% and 40% of patients had grade 3 and 4 SS at the 1- and 3-year follow-ups, respectively. The SS grade was lower in the TNS group than in the control group at the 1- and 3-year follow-ups (p < 0.001). The frequencies of CH in both groups were no significant difference at the 1- and 3-year follow-ups. The JOA scores of the TNS group significantly improved at 1 year after surgery and were comparable to control group.

Conclusion

The TNS stem reduced SS at 1 and 3 years after THA compared to the proximal-engaging cementless stem, although the shapes of the stems matched. The TNS stem could reduce SS, stem loosening, and periprosthetic fractures.

Trial registration: Current Controlled Trials. ISRCTN21241251. https://www.isrctn.com/search?q=21241251. The date of registration was October 26, 2021. Retrospectively registered.

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Title: TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems
Authors: Kazuyoshi Baba
Yu Mori
Daisuke Chiba
Yoshiyuki Kuwahara
Hiroaki Kurishima
Hidetatsu Tanaka
Atsushi Kogure
Masayuki Kamimura
Norikazu Yamada
Susumu Ohtsu
Masamizu Oyama
Naoya Masahashi
Shuji Hanada
Eiji Itoi
Toshimi Aizawa
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Hip-TEP
Hip-TEP
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01199-z

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TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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