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Bone remodeling after total hip arthroplasty with a short stemmed metaphyseal loading implant: Finite element analysis validated by a prospective DEXA investigation
Author(s) -
Lerch Matthias,
Kurtz Agnes,
StukenborgColsman Christina,
Nolte Ingo,
Weigel Nelly,
Bouguecha Anas,
Behrens Bernd A.
Publication year - 2012
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.22120
Subject(s) - stress shielding , calcar , bone remodeling , trochanter , implant , diaphysis , femur , medicine , greater trochanter , orthodontics , dentistry , lesser trochanter , bone mass , bone density , total hip arthroplasty , materials science , osteoporosis , surgery , bone mineral
In total hip arthroplasty (THA), short stemmed cementless implants are used because they are thought to stimulate physiological bone remodeling and reduce stress shielding. We performed a numerical investigation on bone remodeling after implantation of a specific short stemmed implant using finite element analysis (FEA). Overall bone mass loss was 2.8% in the entire femur. Bone mass decrease was mostly found in the proximal part of the calcar and in the greater trochanter due to the vast cross section of the implant, probably leading to stress shielding. In the diaphysis, no change in the apparent bone density was proven. The assumptions made agreed well with bone remodeling data from THA recipients who underwent dual‐energy X‐ray absorptiometry. However, the clinical investigation revealed a bone mass increase in the minor trochanter region that was less pronounced in the FEA. Further comparisons to other stem designs must be done to verify if the relative advantages of the investigated implant can be accepted. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1822–1829, 2012