Evaluation of femoral strains with cementless proximal-fill femoral implants of varied stem length

Arno, Sally; Fetto, Joseph; Nguyen, Nguyen Q.; Kinariwala, Neal; Takemoto, Richelle; Oh, Cheongeun; Walker, Peter S.

doi:10.1016/j.clinbiomech.2012.03.006

Cited by 40 publications

(25 citation statements)

References 30 publications

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“…The clear distal load transfer after the implantation of both short stems demonstrated in this study is congruent with previous studies, which have found a similar distally shifting load distribution pattern as a result of implant insertion (24,61,62). Despite the fact that short stem femoral implants have displayed a better biomechanical behavior preserving a stain distribution closer to the intact bone according to previous studies (24,28,42,43,(63)(64)(65), the implantation of a stiffer material absorbs the load and transfers it distally, leaving the proximal region of the calcar somewhat stress-shielded. The data presented here demonstrate that strain shielding and proximal unloading of the femur occurred even when using short-stem implants.…”

Section: Discussionsupporting

confidence: 92%

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Tatani

Megas

Παναγόπουλος

et al. 2020

Preprint

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Background: The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants, the TRI-LOCK Bone Preservation Stem, a shortened conventional stem and the Minima S Femoral Stem, an even shorter and anatomically shaped stem, based on experiments and numerical simulations. Furthermore, finite element models of implant–bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique. Results: Design differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses revealed a reasonable agreement between the numerical and experimental data in the majority of cases. Conclusion: The study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, a proximal stress shielding effect was noted after the implantation of both short stem designs. Design specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.

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Section: Discussionsupporting

confidence: 92%

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Tatani

Megas

Παναγόπουλος

et al. 2020

Preprint

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“…DIC strain analysis exhibited that specimens implanted with reduced 222 length prostheses most closely matched the cortical strain distribution patterns of the 223 unimplanted specimens and thus, within this model, would be less likely to initiate a 224 proximal stress shielding response. In a recent study, Arno et al [22] stems across a variety of stem designs [23][24][25][26][27]. Similarly, Decking et al [25] reported 232 significant improvement in strain distribution when comparing a stemless femoral neck 233 prosthesis to two long stemmed prostheses.…”

Section: Femoral Component Micromotion 148mentioning

confidence: 99%

Characterization of Femoral Component Initial Stability and Cortical Strain in a Reduced Stem-Length Design

Small

Hensley

Cook

et al. 2017

The Journal of Arthroplasty

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Our findings demonstrate that within this fit-and-fill stem design, reduction in stem length improved proximal cortical strain distribution and maintained axial and torsional stability on par with other stem designs in a composite femur model. Short-stemmed implants may accommodate less invasive surgical techniques while facilitating more physiological femoral loading without sacrificing primary implant stability.

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“…Biomechanical research relies on animal models for convenient and cost-effective preliminary evaluation. In particular, accurate proxies are essential to orthopaedic surgical device development, including implant prototypes [ 1 , 2 ], joint replacements, other devices such as suture anchors [ 3 ], and accurate representations of ballistic injury. Comparing the morphological and biomechanical characteristics of animal bones and soft tissue structures with those of humans is the basis for development of suitable models for both in vivo and in situ evaluation of devices and injury models.…”

Section: Introductionmentioning

confidence: 99%

The Odocoileus virginianus Femur: Mechanical Behavior and Morphology

et al. 2016

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Biomechanical research relies heavily on laboratory evaluation and testing with osseous animal structures. While many femora models are currently in use, including those of the European red deer (Cervus elaphus), the Odocoileus virginianus femur remains undocumented, despite its regional abundance in North America. The objective of this study was to compare biomechanical and morphological properties of the Odocoileus virginianus femur with those of the human and commonly used animal models. Sixteen pairs of fresh-frozen cervine femora (10 male, 6 female, aged 2.1 ± 0.9 years) were used for this study. Axial and torsional stiffnesses (whole bone) were calculated following compression and torsion to failure tests (at rates of 0.1 mm/sec and 0.2°/sec). Lengths, angles, femoral head diameter and position, periosteal and endosteal diaphyseal dimensions, and condylar dimensions were measured. The results show that the cervine femur is closer in length, axial and torsional stiffness, torsional strength, and overall morphology to the human femur than many other commonly used animal femora models; additional morphological measurements are comparable to many other species’ femora. The distal bicondylar width of 59.3mm suggests that cervine femora may be excellent models for use in total knee replacement simulations. Furthermore, the cervine femoral head is more ovoid than other commonly-used models for hip research, making it a more suitable model for studies of hip implants. Thus, with further, more application-specific investigations, the cervine femur could be a suitable model for biomechanical research, including the study of ballistic injuries and orthopaedic device development.

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Evaluation of femoral strains with cementless proximal-fill femoral implants of varied stem length

Cited by 40 publications

References 30 publications

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Characterization of Femoral Component Initial Stability and Cortical Strain in a Reduced Stem-Length Design

The Odocoileus virginianus Femur: Mechanical Behavior and Morphology

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