Author:
Solou Konstantina,Solou Anna Vasiliki,Tatani Irini,Lakoumentas John,Tserpes Konstantinos,Megas Panagiotis
Abstract
AbstractStress shielding and aseptic loosening are complications of short stem total hip arthroplasty, which may lead to hardware failure. Stems with increased porosity toward the distal end were discovered to be effective in reducing stress shielding, however, there is a lack of research on optimized porous distribution in stem’s coating. This study aimed to optimize the distribution of the coefficient of friction of a metaphyseal femoral stem, aiming for reducing stress shielding in the proximal area. A finite element analysis model of an implanted, titanium alloy short-tapered wedge stem featuring a porous coating made of titanium was designed to simulate a static structural analysis of the femoral stem's behavior under axial loading in Analysis System Mechanical Software. For computational feasibility, 500 combinations of coefficients of friction were randomly sampled. Increased strains in proximal femur were found in 8.4% of the models, which had decreased coefficients of friction in middle medial areas of porous coating and increased in lateral proximal and lateral and medial distal areas. This study reported the importance of the interface between bone and middle medial and distal lateral areas of the porous coating in influencing the biomechanical behavior of the proximal femur, and potentially reducing stress shielding.
Publisher
Springer Science and Business Media LLC
Reference46 articles.
1. Ulivi, M. et al. Clinical performance, patient reported outcome, and radiological results of a short, tapered, porous, proximally coated cementless femoral stem: Results up to seven years of follow-up. J. Arthroplast. 33, 1133–1138. https://doi.org/10.1016/j.arth.2017.11.046 (2018).
2. Hayashi, S. et al. Daily activity and initial bone mineral density are associated with periprosthetic bone mineral density after total HIP Arthroplasty. HIP Int. 26, 169–174. https://doi.org/10.5301/hipint.5000320 (2016).
3. Albers, A. et al. Favorable results of a short, tapered, highly porous, proximally coated cementless femoral stem at a minimum 4-year follow-up. J. Arthroplast. https://doi.org/10.1016/j.arth.2015.08.020 (2015).
4. Tatani, I., Solou, K. & Megas, P. Short femoral stems with metaphyseal or meta-diaphyseal fitting in total hip arthroplasty: A systematic review. Acta Orthop. Traumatol. Hellenica 73, 45–59 (2022).
5. Guo, J. et al. Comparison of tri-lock bone preservation stem and the conventional standard corail stem in primary total hip arthroplasty. Orthop. Surg. 13, 749–757. https://doi.org/10.1111/os.12946 (2021).