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

BMC Musculoskeletal Disorders

Ching-Shiow Tseng¹  Shang-Chih Lin²  Wen-Chi Tsai³  Chun-Ming Chen¹ 

[1] Department of Mechanical Engineering, National Central University, Taoyuan, Taiwan;Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, No. 43, Sec. 4, Keelung Rd, Taipei 106, Taiwan;Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan

关键词: Finite-element;    Stress-shielding;    Nonstemmed;    Stemmed;    Hip;   

Others  :  1127619
DOI  :  10.1186/1471-2474-15-312

 received in 2014-04-02, accepted in 2014-09-18,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

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