title: Biomechanics of a short stem: In vitro primary stability and stress shielding of a conservative cementless hip stem.
abstract: Short stem prostheses provide conservative surgery and favorable metaphyseal load transmission. However, clinical long-term results are lacking. Therefore, in vitro trials can be used to predict bone-implant performance. In this in vitro study, primary stability and stress shielding of a new cementless short stem implant was evaluated in comparison to a straight stem using nine pairs of human cadaver femurs. Primary stability, including reversible micromotion and irreversible migration, was assessed in a hip simulator. Furthermore, changes in the pattern of cortical strain were evaluated. The short stem was more resistant to reversible micromotion and irreversible migration into retroversion. Axial stability was similar, with mean reversible micromotions of 9 µm for the short stem and 7 µm for the straight stem. Proximal load transmission was more physiological with the short stem, though both implants could not avoid stress shielding in Gruen zones 1 and 7. Primary stability of the short stem prosthesis was not negatively influenced compared to the straight shaft. Furthermore, proximal femoral strain pattern was more physiological after insertion of the short stem prosthesis.
authors.affiliation: Department of Orthopaedic Surgery, Centre of Musculoskeletal Research, University Hospital Ulm, Ulm, Oberer Eselsberg 45, Ulm, 89081, Germany. ralf.bieger@uni-ulm.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Bieger
authors.forename: Anita
authors.initials: A
authors.lastname: Ignatius
authors.forename: Heiko
authors.initials: H
authors.lastname: Reichel
authors.forename: Lutz
authors.initials: L
authors.lastname: Dürselen
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D002102:Cadaver; D002484:Cementation; D019544:Equipment Failure Analysis; D005260:Female; D005269:Femur; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013314:Stress, Mechanical; D014025:Titanium
chemical_list: D014025:Titanium