Bone Remodeling after Total Hip Arthroplasty with a Short Stemmed Metaphyseal Loading Implant: Finite Element Analysis Validated by a Prospective DEXA Investigation

authored by: Matthias Lerch, Agnes Kurtz, Christina Stukenborg-Colsman, Ingo Nolte, Nelly Weigel, Anas Bouguecha, Bernd A. Behrens
Abstract: 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.
Organisation(s): Institute of Metal Forming and Metal Forming Machines
External Organisation(s): Hannover Medical School (MHH)
University of Veterinary Medicine of Hannover, Foundation
Type: Article
Journal: Journal of orthopaedic research
Volume: 30
Pages: 1822-1829
No. of pages: 8
ISSN: 0736-0266
Publication date: 18.04.2012
Publication status: Published
Peer reviewed: Yes
ASJC Scopus subject areas: Orthopedics and Sports Medicine
Electronic version(s): https://doi.org/10.1002/jor.22120 (Access: Unknown)
: Details in the research portal "Research@Leibniz University"

BibTeX

@article{01f94c3ed1c74b5b9e60490f3e3a9789,
title = "Bone Remodeling after Total Hip Arthroplasty with a Short Stemmed Metaphyseal Loading Implant: Finite Element Analysis Validated by a Prospective DEXA Investigation",
abstract = "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.",
keywords = "bone remodeling, dual-energy X-ray absorptiometry, finite element analysis, short stemmed implant, total hip arthroplasty",
author = "Matthias Lerch and Agnes Kurtz and Christina Stukenborg-Colsman and Ingo Nolte and Nelly Weigel and Anas Bouguecha and Behrens, {Bernd A.}",
year = "2012",
month = apr,
day = "18",
doi = "10.1002/jor.22120",
language = "English",
volume = "30",
pages = "1822--1829",
journal = "Journal of orthopaedic research",
issn = "0736-0266",
publisher = "Wiley-Blackwell",
number = "11",
}