NDLI: Stress distributions of the short stem and the tapered wedge stem at different alignments: a finite element analysis study

Content Provider	Springer Nature : BioMed Central
Author	Kaku, Nobuhiro Pramudita, Jonas A. Yamamoto, Kansei Hosoyama, Tsuguaki Tsumura, Hiroshi
Abstract	Background The mechanical effects of stem length reduction and stem alignment on the surrounding femur remain unknown. This study directly compared the stress distribution on the surrounding femur of existing tapered wedge stems and short stems and examined the properties of stress distribution at different stem alignments in three dimensions. Methods Finite element analysis was conducted for standing and walking. The cementless stem was appropriately sized to ensure adequate contact with the medial cortical bone line that contours the medullary cavity. The stem neck axis was aligned with the femoral neck axis in the mid-position and placed in 2° of the varus and valgus, 3° of flexion and extension, and 10° and 40° of anteversion. Results Regardless of stem length, the trend of stress distribution was similar. The short stem generated less stress around the stem than the tapered wedge stem. In the coronal plane, the effect of varus and valgus deflection was small. In the sagittal plane, the stress generated around the stem was higher in the extended position than in the flexed position. In the horizontal plane, the stress generated around the stem was higher when the stem anteversion was smaller. Conclusions Depending on the design, short stems can reduce the stress on the surrounding bone, compared to a longer tapered wedge with similar stress distribution. Additionally, a short stem can reduce the effect of the varus position. Stems should be placed to achieve stable initial fixation while noting that stresses increase with extension and reduced anteversion.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-022-03425-6.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-022-03425-6
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	17
Language	English
Publisher	BioMed Central
Publisher Date	2022-12-09
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Finite element analysis Arthroplasty Hip Femur Prosthesis
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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