Biomechanics of a short stem: In vitro primary stability and stress shielding of a conservative cementless hip stem

Short stem prostheses provide conservative surgery and favorable metaphyseal load transmission. However, clinical long‐term results are lacking. Therefore, in vitro trials can be used to predict bone‐implant performance. In this in vitro study, primary stability and stress shielding of a new cementl...

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Bibliographic Details
Published in:Journal of orthopaedic research 2013-08, Vol.31 (8), p.1180-1186
Main Authors: Bieger, Ralf, Ignatius, Anita, Reichel, Heiko, Dürselen, Lutz
Format: Article
Language:English
Subjects:
arthroplasty
Arthroplasty, Replacement, Hip - instrumentation
Biomechanical Phenomena
Cadaver
Cementation
Equipment Failure Analysis
Female
Femur
hip
Hip Prosthesis
Humans
Male
mechanical
micromotion
Middle Aged
Prosthesis Design
Prosthesis Failure
stress
Stress, Mechanical
Titanium
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Summary:Short stem prostheses provide conservative surgery and favorable metaphyseal load transmission. However, clinical long‐term results are lacking. Therefore, in vitro trials can be used to predict bone‐implant performance. In this in vitro study, primary stability and stress shielding of a new cementless short stem implant was evaluated in comparison to a straight stem using nine pairs of human cadaver femurs. Primary stability, including reversible micromotion and irreversible migration, was assessed in a hip simulator. Furthermore, changes in the pattern of cortical strain were evaluated. The short stem was more resistant to reversible micromotion and irreversible migration into retroversion. Axial stability was similar, with mean reversible micromotions of 9 µm for the short stem and 7 µm for the straight stem. Proximal load transmission was more physiological with the short stem, though both implants could not avoid stress shielding in Gruen zones 1 and 7. Primary stability of the short stem prosthesis was not negatively influenced compared to the straight shaft. Furthermore, proximal femoral strain pattern was more physiological after insertion of the short stem prosthesis. (c) 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1180–1186, 2013
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.22349