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Purpose: The number of primary total hip arthroplasties (THA) is steadily increasing. Over the last decade numerous so-called short stem hip arthroplasties were introduced on the market. The aim of these implants with a predominantly metaphyseal anchorage is to reduce stress shielding and thereby the risk of aseptic loosening. One of the short stem arthroplasties with predominant metaphyseal fixation is the METHA® short stem (Aesculap, Tuttlingen, Germany). In order to reconstruct the biomechanics the METHA stem is available in different sizes with different centrum-collum-diaphysis-angles (CCD-angle). In this study, we want to address the research question of how the size of the implant and different CCD-angles influence the strain patterns of the proximal femur. Methods: Three different stem sizes (size 2, 3 and 4 – CCD-angle 130°) and three stems with different CCD-angles (size 3 – 120°, 130° and 135° CCD-angle) were successively implanted in a synthetic femur. Eight strain gauges monitored the corresponding strain patterns of the proximal femur. Results: Independent of stem size and CCD-angle only small changes in the strains were recorded around the distal part of the METHA stem when compared to the intact femur. However, all stems increased the strains in the region of the calcar. This was most pronounced by smaller CCD-angles and major sizes. Conclusion: The stem size and CCD-angle primarily influence the region of the calcar. Greater sizes and smaller CCD-angles lead to increased strains at the calcar. The other regions are hardly influenced by the stem size and CCDangle of the femoral component.
Czasopismo
Rocznik
Tom
Strony
141--149
Opis fizyczny
Bibliogr. 27 poz., rys., wykr.
Twórcy
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
autor
- Hannover Medical School, Department of Orthopaedic Surgery, Anna-von-Borries-Str. 1–7, 30625 Hannover, Germany
Bibliografia
- [1] BANERJEE S., PIVEC R., ISSA K., HARWIN S.F., MONT M.A., KHANUJA H.S., Outcomes of short stems in total hip arthroplasty, Orthopedics, 2013, 36(9), 700–707.
- [2] BRAUN A., SABAH A., Two-year results of a modular short hip stem prosthesis – a prospective study, Z. Orthop. Unfall, 2009, 147(6), 700–706.
- [3] CRISTOFOLINI L., JUSZCZYK M., TADDEI F., FIELD R.E., RUSHTON N., VICECONTI M., Stress shielding and stress concentration of contemporary epiphyseal hip prostheses, Proc. Inst. Mech. Eng. H, 2009, 223(1), 27–44.
- [4] CRISTOFOLINI L., JUSZCZYK M., TADDEI F., VICECONTI M., Strain distribution in the proximal human femoral metaphysis, Proc. Inst. Mech. Eng. H, 2009, 223(3), 273–288.
- [5] DAVIS E.T., OLSEN M., ZDERO R., PAPINI M., WADDELL J.P., SCHEMITSCH E.H., A biomechanical and finite element analysis of femoral neck notching during hip resurfacing, J. Biomech. Eng., 2009, 131(4), 041002.
- [6] DECKING R., PUHL W., SIMON U., CLAES L.E., Changes in strain distribution of loaded proximal femora caused by different types of cementless femoral stems, Clin. Biomech., Avon, Bristol 2006, 21(5), 495–501.
- [7] ENOKSEN C.H., GJERDET N.R., KLAKSVIK J., ARTHURSSON A.J., SCHNELL-HUSBY O., WIK T.S., Deformation pattern and load transfer of an uncemented femoral stem with modular necks. An experimental study in human cadaver femurs, Clin. Biomech., Avon, Bristol 2016, 32, 28–33.
- [8] FLOERKEMEIER T., GRONEWOLD J., BERNER S., OLENDER G., HURSCHLER C., WINDHAGEN H., VON LEWINSKI G., The influence of resection height on proximal femoral strain patterns after Metha short stem hip arthroplasty: an experimental study on composite femora, Int. Orthop., 2013, 37(3), 369–377.
- [9] FLOERKEMEIER T., TSCHEUSCHNER N., CALLIESS T., EZECHIELI M., FLOERKEMEIER S., BUDDE S., WINDHAGEN H., VON LEWINSKI G., Cementless short stem hip arthroplasty METHA®) as an encouraging option in adults with osteonecrosis of the femoral head, Arch. Orthop. Trauma Surg., 2012, 132(8), 1125–1131.
- [10] FOTTNER A., SCHMID M., BIRKENMAIER C., MAZOOCHIAN F., PLITZ W., VOLKMAR J., Biomechanical evaluation of two types of short-stemmed hip prostheses compared to the trust plate prosthesis by three-dimensional measurement of micromotions, Clin. Biomech., Avon, Bristol 2009, 24(5), 429–434.
- [11] GÖRTZ W., NAGERL U.V., NAGERL H., THOMSEN M., Spatial micromovements of uncemented femoral components after torsional loads, J. Biomech. Eng., 2002, 124(6), 706–713.
- [12] GOSHULAK P., SAMIEZADEH S., AZIZ M.S., BOUGHERARA H., ZDERO R., SCHEMITSCH E.H., The biomechanical effect of anteversion and modular neck offset on stress shielding for short-stem versus conventional long-stem hip implants, Med. Eng. Phys., 2016. DOI: 10.1016.
- [13] GRONEWOLD J., BERNER S., OLENDER G., HURSCHLER C., WINDHAGEN H., VON LEWINSKI G, FLOERKEMEIER T., Changes in strain pattern after implantation of a short stem with metaphyseal anchorage compared to a standard stem: an experimental study in synthetic bone, Orthop. Rev. Pavia, 2014, 6, 5211, 25–32.
- [14] GULOW J., SCHOLZ R., F. VON SALIS-SOGLIO, Short-stemmed endoprostheses in total hip arthroplasty, Orthopade, 2007, 36(4), 353–359.
- [15] HEINER A.D., BROWN T.D., Structural properties of a new design of composite replicate femurs and tibias, J. Biomech., 2001, 34(6), 773–781.
- [16] HUTT J., HARB Z., GILL I., KASHIF F., MILLER J., DODD M., Ten year results of the collum femoris preserving total hip replacement: a prospective cohort study of seventy five patients, Int. Orthop., 2013, 38(5), 917–22.
- [17] KHANNA G., BOURGEAULT C.A., KYLE R.F., Biomechanical comparison of extended trochanteric osteotomy and slot osteotomy for femoral component revision in total hip arthroplasty, Clin. Biomech., Avon, Bristol 2007, 22(5), 599–602.
- [18] LACKO M., FILIP V., CELLAR R., VASKO G., Our experience with the metha short hip stem, Acta Chir. Orthop. Traumatol. Cech., 2014, 81(1), 70–76.
- [19] LEARMONTH I.D., YOUNG C., RORABECK C., The operation of the century: total hip replacement, Lancet, 2007, 370(9597), 1508–1519.
- [20] LERCH M., VON DER HAAR-TRAN A., WINDHAGEN H., BEHRENS B.A., WEFSTAEDT P., STUKENBORG-COLSMAN C.M., Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study, Int. Orthop., 2011, 36(3), 533–538.
- [21] MIHALKO W.M., SALEH K.J., HELLER M.O., MOLLARD B., KONIG C., KAMMERZELL S., Femoral neck cut level affects positioning of modular short-stem implant, Orthopedics, 2009, 32(10 Suppl), 18–21.
- [22] PATEL R.M., STULBERG S.D., The rationale for short uncemented stems in total hip arthroplasty, Orthop. Clin. North Am., 2014, 45(1), 19–31.
- [23] THOREY F., HOEFER C., BDI-TABARI N., LERCH M., BUDDE S., WINDHAGEN H., Clinical results of the metha short hip stem: a perspective for younger patients?, Orthop. Rev., (Pavia), 2013, 5(4), e34.
- [24] UMEDA N., SAITO M., SUGANO N., OHZONO K., NISHII T., SAKAI T., YOSHIKAWA H., IKEDA D., MURAKAMI A., Correlation between femoral neck version and strain on the femur after insertion of femoral prosthesis, J. Orthop. Sci., 2003, 8(3), 381–386.
- [25] VON LEWINSKI G., FLOERKEMEIER T., 10-year experience with short stem total hip arthroplasty, Orthopedics, 2015, 38(3 Suppl), S51–S56.
- [26] VON SCHULZE PELLENGAHR C., FOTTNER A., UTZSCHNEIDER S., SCHMITT-SODY M., TESKE W., LICHTINGER T., ESENWEIN S.A., Uncemented arthroplasty of the hip, Orthopade, 2009, 38(5), 461–470.
- [27] WITTENBERG R.H., STEFFEN R., WINDHAGEN H., BUCKING P., WILCKE A., Five-year results of a cementless short-hip-stem prosthesis, Orthop. Rev., Pavia, 2013, 5(1), e4.
Uwagi
Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę (zadania 2017).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-6859f717-f003-4901-b477-2e1f428b06c2