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

European Journal of Medical Research

Research

Susumu Ohtsu¹  Norikazu Yamada²  Masamizu Oyama²  Eiji Itoi³  Masayuki Kamimura⁴  Toshimi Aizawa⁴  Yu Mori⁴  Daisuke Chiba⁴  Yoshiyuki Kuwahara⁴  Kazuyoshi Baba⁴  Hidetatsu Tanaka⁴  Hiroaki Kurishima⁴  Atsushi Kogure⁴  Naoya Masahashi⁵  Shuji Hanada⁵ 

[1] Department of Orthopaedic Surgery, Osaki Citizen Hospital, 3-8-1 Furukawahonami, 989-6183, Osaki, Miyagi, Japan;Department of Orthopaedic Surgery, Sendai Red Cross Hospital, 2‑43‑3 Yagiyamahoncho, Taihaku‑ku, 982-8501, Sendai, Miyagi, Japan;Department of Orthopaedic Surgery, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, 981-0911, Sendai, Miyagi, Japan;Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, 980-8574, Sendai, Miyagi, Japan;Institute for Materials Research, Tohoku University, 2-1-1 Katahira, Aoba-ku, 980-8577, Sendai, Miyagi, Japan;

关键词: TiNbSn alloy;    Total hip arthroplasty;    Stress shielding;    Low Young’s modulus;    Functionally graded characteristics;   

DOI  :  10.1186/s40001-023-01199-z

 received in 2022-10-13, accepted in 2023-06-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThis 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.ResultsNone 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.ConclusionThe 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.

【 授权许可】

CC BY   
© The Author(s) 2023

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