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Published in: Irish Journal of Medical Science (1971 -) 3/2010

01-09-2010 | Original Article

Periprosthetic fractures may be more likely in cementless femoral stems with sharp edges

Authors: K. Hu, X. Zhang, J. Zhu, C. Wang, W. Ji, X. Bai

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2010

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Abstract

Background

Many contour designs have been developed to improve the femoral stem in cementless total hip arthroplasty.

Aims

To assess the initial interfacial micromotion and stress distribution.

Methods

The prosthesis–bone interfacial micromotions and stress distributions of four commonly used femoral stems were assessed by finite element simulation: Alloclassic, Ribbed Anatomic, VerSys, and Secur-Fit. The proximal interfacial micromotions and stress distributions were calculated under the loading conditions of stair climbing. Three-dimensional micromotions were calculated in three proximal sections distal to the osteotomy level with 400 mm between each section. Medial, anterior, lateral and posterior points in each section were selected for calculations.

Results

The micromotions were <100 μm at all the selected points. Significant stress was detected along the sharp corners and ribs of the Alloclassic and Ribbed Anatomic stems, respectively.

Conclusions

Significant stresses are associated with the stems with sharp edges.
Literature
1.
go back to reference Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures—a comparison between cemented and uncemented hemiarthroplasties. Injury 36:424–429CrossRefPubMed Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures—a comparison between cemented and uncemented hemiarthroplasties. Injury 36:424–429CrossRefPubMed
2.
go back to reference Lindahl H (2007) Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury 38:651–654CrossRefPubMed Lindahl H (2007) Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury 38:651–654CrossRefPubMed
3.
go back to reference Engh CA, O’Connor D, Jasty M et al (1992) Quantification of implant micromotion, strain shielding, and bone resorption with porous-coated anatomic medullary locking femoral prostheses. Clin Orthop Relat Res 285:13–29PubMed Engh CA, O’Connor D, Jasty M et al (1992) Quantification of implant micromotion, strain shielding, and bone resorption with porous-coated anatomic medullary locking femoral prostheses. Clin Orthop Relat Res 285:13–29PubMed
4.
go back to reference Pancanti A, Bernakiewicz M, Viceconti M (2003) The primary stability of a cementless stem varies between subjects as much as between activities. J Biomech 36:777–785CrossRefPubMed Pancanti A, Bernakiewicz M, Viceconti M (2003) The primary stability of a cementless stem varies between subjects as much as between activities. J Biomech 36:777–785CrossRefPubMed
5.
go back to reference Koyama Y, Mitsui N, Suzuki N et al (2008) Effect of compressive force on the expression of inflammatory cytokines and their receptors in osteoblastic Saos-2 cells. Arch Oral Biol 53:488–496CrossRefPubMed Koyama Y, Mitsui N, Suzuki N et al (2008) Effect of compressive force on the expression of inflammatory cytokines and their receptors in osteoblastic Saos-2 cells. Arch Oral Biol 53:488–496CrossRefPubMed
6.
go back to reference Davidson D, Pike J, Garbuz D et al (2008) Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Jt Surg Am 90:2000–2012CrossRef Davidson D, Pike J, Garbuz D et al (2008) Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Jt Surg Am 90:2000–2012CrossRef
7.
go back to reference Sakai R, Kanai N, Itoman M, Mabuchi K (2006) Assessment of the fixation stiffness of some femoral stems of different designs. Clin Biomech (Bristol, Avon) 21:370–378CrossRef Sakai R, Kanai N, Itoman M, Mabuchi K (2006) Assessment of the fixation stiffness of some femoral stems of different designs. Clin Biomech (Bristol, Avon) 21:370–378CrossRef
8.
go back to reference Sakai R, Itoman M, Mabuchi K (2006) Assessments of different kinds of stems by experiments and FEM analysis: appropriate stress distribution on a hip prosthesis. Clin Biomech (Bristol, Avon) 21:826–833CrossRef Sakai R, Itoman M, Mabuchi K (2006) Assessments of different kinds of stems by experiments and FEM analysis: appropriate stress distribution on a hip prosthesis. Clin Biomech (Bristol, Avon) 21:826–833CrossRef
9.
go back to reference Viceconti M, Muccini R, Bernakiewicz M et al (2000) Large-sliding contact elements accurately predict levels of bone–implant micromotion relevant to osseointegration. J Biomech 33:1611–1618CrossRefPubMed Viceconti M, Muccini R, Bernakiewicz M et al (2000) Large-sliding contact elements accurately predict levels of bone–implant micromotion relevant to osseointegration. J Biomech 33:1611–1618CrossRefPubMed
10.
go back to reference Abdul-Kadir MR, Hansen U, Klabunde R et al (2008) Finite element modelling of primary hip stem stability: the effect of interference fit. J Biomech 41:587–594CrossRefPubMed Abdul-Kadir MR, Hansen U, Klabunde R et al (2008) Finite element modelling of primary hip stem stability: the effect of interference fit. J Biomech 41:587–594CrossRefPubMed
11.
go back to reference Hu KZ, Zhang XL, Wang CT et al (2009) The contour of cementless femoral stem has minor effect on initial periprosthetic von Mises stress distribution: a 3-dimensional finite element analysis. Saudi Med J 30:947–951PubMed Hu KZ, Zhang XL, Wang CT et al (2009) The contour of cementless femoral stem has minor effect on initial periprosthetic von Mises stress distribution: a 3-dimensional finite element analysis. Saudi Med J 30:947–951PubMed
12.
go back to reference Morscher EW (2003) Failures and successes in total hip replacement—why good ideas may not work. Scand J Surg. 92:113–120PubMed Morscher EW (2003) Failures and successes in total hip replacement—why good ideas may not work. Scand J Surg. 92:113–120PubMed
13.
go back to reference Eingartner C (2007) Current trends in total hip arthroplasty. Ortop Traumatol Rehabil. 9:8–14PubMed Eingartner C (2007) Current trends in total hip arthroplasty. Ortop Traumatol Rehabil. 9:8–14PubMed
14.
go back to reference Swanson TV (2005) The tapered press fit total hip arthroplasty: a European alternative. J Arthroplasty 20(4 Suppl 2):63–67CrossRefPubMed Swanson TV (2005) The tapered press fit total hip arthroplasty: a European alternative. J Arthroplasty 20(4 Suppl 2):63–67CrossRefPubMed
15.
go back to reference Marshall DA, Mokris GJ, Reitman DR et al (2004) Cementless titanium tapered-wedge femoral stem: 10- to 15-year follow-up. J Arthroplasty 19:546–552CrossRefPubMed Marshall DA, Mokris GJ, Reitman DR et al (2004) Cementless titanium tapered-wedge femoral stem: 10- to 15-year follow-up. J Arthroplasty 19:546–552CrossRefPubMed
16.
go back to reference Fortina M, Carta S, Gambera D et al (2006) Total hip arthroplasty with a ribbed anatomic HA coated stem. J Orthop Traumatol 7:122–125CrossRef Fortina M, Carta S, Gambera D et al (2006) Total hip arthroplasty with a ribbed anatomic HA coated stem. J Orthop Traumatol 7:122–125CrossRef
17.
go back to reference Sweetnam DI, Lavelle J, Allwood WM, Cohen B (1995) Poor results of the Ribbed Hip System for cementless replacement. J Bone Jt Surg Br 77:366–368 Sweetnam DI, Lavelle J, Allwood WM, Cohen B (1995) Poor results of the Ribbed Hip System for cementless replacement. J Bone Jt Surg Br 77:366–368
18.
go back to reference Klein GR, Levine HB, Nafash SC et al (2009) Total hip arthroplasty with a collarless, tapered, fiber metal proximally coated femoral stem minimum 5-year follow-up. J Arthroplasty 24:579–585CrossRefPubMed Klein GR, Levine HB, Nafash SC et al (2009) Total hip arthroplasty with a collarless, tapered, fiber metal proximally coated femoral stem minimum 5-year follow-up. J Arthroplasty 24:579–585CrossRefPubMed
19.
go back to reference Incavo SJ, Beynnon BD, Coughlin KM (2008) Total hip arthroplasty with the Secur-Fit and Secur-Fit plus femoral stem design a brief follow-up report at 5 to 10 years. J Arthroplasty 23:670–676CrossRefPubMed Incavo SJ, Beynnon BD, Coughlin KM (2008) Total hip arthroplasty with the Secur-Fit and Secur-Fit plus femoral stem design a brief follow-up report at 5 to 10 years. J Arthroplasty 23:670–676CrossRefPubMed
20.
go back to reference Shultz TR, Blaha JD, Gruen TA, Norman TL (2006) Cortical bone viscoelasticity and fixation strength of press-fit femoral stems: finite element model. J Biomech Eng 128:7–12CrossRefPubMed Shultz TR, Blaha JD, Gruen TA, Norman TL (2006) Cortical bone viscoelasticity and fixation strength of press-fit femoral stems: finite element model. J Biomech Eng 128:7–12CrossRefPubMed
Metadata
Title
Periprosthetic fractures may be more likely in cementless femoral stems with sharp edges
Authors
K. Hu
X. Zhang
J. Zhu
C. Wang
W. Ji
X. Bai
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Irish Journal of Medical Science (1971 -) / Issue 3/2010
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-009-0442-1

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