Calcar unloading after hip replacement: A cadaver study of femoral stem designs

Djerf, Krister; Gillquist, Jan

doi:10.3109/17453678709146448

Cited by 35 publications

(6 citation statements)

References 18 publications

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“…Attempts have been made to overcome proximal strain shielding through a number of designs; cementless, porous coating placement on the femoral prostheses and porous bony in-growth (Otani et al 1993, Huiskes and van Rietbergen 1995, Malchau et al 1995, Pernell et al 1995, Pritchett 1995, Sedlacek et al 1997, Wixson et al 1997, less stiff or isoelastic prosthesis to more closely match the modulus of the bone (Djerf andGillquist 1987, Otani et al 1993); collared (Djerf and Gillquist 1987, Meunier et al 1990, Manley et al 1995, Pernell et al 1995 or stemless prostheses (Munting and Verhelpen 1995), to allow a direct load on the calcar. Proximal fit and fill (Pernell et al 1995) and variations of distal fit (Jasty et al 1994) are other reported ways to modify proximal stress or strain shielding.…”

Section: Introductionmentioning

confidence: 98%

Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement

Gillies

Kohan

Cordingley

2007

Computer Methods in Biomechanics and Biomedical Engineering

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Total hip arthroplasty represents a major surgical achievement for pain relief and restoration of lifestyle quality due to the joint disease of osteoarthritis. Total hip replacement has evolved over the past 30 years utilising a variety of biocompatible materials, geometric shapes and fixation techniques. The main objective of this study is to investigate the long-term effects of strain adaptive bone remodelling due to the influence of a novel titanium cementless femoral hip replacement. The period of on-growth has been taken into account and the simulation has been run to predict the remodelling behaviour for a 36-month period. The main conclusion from this analysis is that the implant does shield the calcar to a similar degree as other cementless femoral hip designs. It does, however, tend to cause bone to be laid down along its length. This may, in part, be due to the novel geometry of the implant interlocking with and loading the bone.

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Section: Introductionmentioning

confidence: 98%

Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement

Gillies

Kohan

Cordingley

2007

Computer Methods in Biomechanics and Biomedical Engineering

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“…Vander Sloten et al [27] found the stem shape to alter the strain distribution. Djerf et al [28] found that stem curvature does not affect load transfer. Fulghum et al [29] reported that the stem geometry affects load transfer less than the stem material does.…”

Section: Introductionmentioning

confidence: 99%

Towards the standardization of in vitro load transfer investigations of hip prostheses

Sutton

Lessner

et al. 1999

The Journal of Strain Analysis for Engineering Design

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Many types of hip prosthesis exist on the market, and no standard exists for testing their functionality. There is a lack of agreement in the literature about the relevance of several design parameters on the load transfer between the femoral stem and bone. This can be explained considering the lack of investigations on the methodology of load transfer measurements. A testing protocol for such purpose must fulfil three requirements: it must be physiological, it must be repeatable and reproducible and it must be sensitive to different prostheses.A methodological investigation is presented that was necessary to design a repeatable and reproducible protocol. The loading and constraints were derived from physiological data. The set-up and protocol were enhanced by means of (a) selection of an appropriate test specimen, (b) definition of reproducible reference systems, (c) sensitivity analyses on the sources of experimental error and (d) modification of the loading system to minimize the sources of error. The variability of results was as low as 0.8 per cent for repetitions on the same specimen, and 11 per cent between femurs.The capability of the protocol of detecting differences between stems was tested on different prostheses, including a prototype device. Significant differences between the load transfer patterns for the different designs were detected. The prototype device yielded satisfactory results.

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“…The Butel prosthesis was designed to obtain flexibility similar to the proximal femur by using four rods (titanium LIIloy) connected proximally and distally. It has been shown to distribute the forces similar to the normal femur (Djerf and Gillquist 1987) and should therefore exhibit fewer signs of stress-shielding in the long run. In contrast the PCA femoral component is a rigid, anatomically-shaped prosthesis (chroniiunicobalt alloy) with a proximal porous coating.…”

Section: Methodsmentioning

confidence: 99%

Tc-scintimetry in 56 cementless hip arthroplasties: A prospective, randomized comparison of two femoral components

Jacobsson¹,

Djerf²,

Gillquist³

et al. 1994

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Calcar unloading after hip replacement: A cadaver study of femoral stem designs

Cited by 35 publications

References 18 publications

Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement

Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement

Towards the standardization of in vitro load transfer investigations of hip prostheses

Tc-scintimetry in 56 cementless hip arthroplasties: A prospective, randomized comparison of two femoral components

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