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Strain shielding inspired re-design of proximal femoral stems for total hip arthroplasty
Publikationstyp
Journal Article
Date Issued
2017-11-01
Sprache
English
Author(s)
Journal
Volume
35
Issue
11
Start Page
2534
End Page
2544
Citation
Journal of Orthopaedic Research 35 (11): 2534-2544 (2017)
Publisher DOI
Scopus ID
Publisher
Wiley
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement. Finite element methods were used to compare healthy and implanted models. The local mechanics strains/stresses in the intact and implanted femurs were determined under patient-specific muscle and joint contact forces. Results suggest that small changes in implant geometry and material properties have no major effect on strain shielding. Furthermore, it was found that improvement depends on a dramatic re-design of the original implant design. Whereas the benefit of this strategy of modification of the original geometry of a given short-stemmed hip consists in reduced bone remodeling, care should be taken with regard to long-term bone anchorage and implant fatigue strength. It is also shown that geometrical and material changes have a limited potential in avoiding strain shielding even in short-stemmed implants. Finally, it is suggested that an understanding of the influence of these changes on the strain distribution within the bone can guide in the process of optimizing the current stem designs toward minimal strain shielding effects. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2534–2544, 2017.
Subjects
bone
computational modeling
hip and knee arthroplasty, finite element analysis
hip and knee arthroplasty, mechanics—kinematics
hip, hip and knee arthroplasty
DDC Class
610: Medicine, Health