The influence of prosthetic stem stiffness and of a calcar collar on stresses in the proximal end of the femur with a cemented femoral component.

Lewis, John L.; Askew, Michael J.; Wixson, Richard L.; Krámer, Gerald M.; Tarr, Richard R.

doi:10.2106/00004623-198466020-00016

Cited by 143 publications

(59 citation statements)

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“…Similar experiments have been described by Andriacchi et al (1976). Brockhurst & Svensson (1977), Oh & Harris (1978), McBeath et al (1979), , Rohlman et al (1983), Huiskes (1980), Voilin (1983), Lewis et al (1984). and Panjabi et al (1985).…”

Section: Discussionsupporting

confidence: 78%

“…The reduction found by us is of the same magnitude as previously described by others. We have confirmed that a collar significantly increases calcar load even with the same stem design (see Oh & 27 29 22 59 75 82 49 42 68 75 80 04 46 41 63 50 80 83 62 44 75 84 82 85 38 33 66 68 81 83 55 39 54 69 79 81 29 32 56 47 74 84 54 41 67 72 83 84 76 82 44 38 46 71 67 44 63 83 85 84 40 41 60 62 81 84 52 32 62 62 80 Harris 1978, Lewis et al 1984, Ytteram et al 1980. The load reduction in the proximal femur seems to be large enough to explain the resorption of the calcar sometimes -seen clinically (Hierton et al 1983).…”

Section: Discussionmentioning

confidence: 99%

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

Djerf

Gillquist

1987

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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

Djerf

Gillquist

1987

Acta Orthopaedica Scandinavica

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“…Therefore cobalt-chromium seems to be the best material for THA. Previous numerical models 43,44 have shown, however, that a cobalt-chromium stem unloads the proximal femur to a higher degree than a titanium stem and that this may enhance stress-shielding. 22,26 Theoretically, less stiff implants reduce stress within the stem and transfer load over a greater area of the cortical bone.…”

Section: Discussionmentioning

confidence: 97%

Osseointegration of Ti6Al4V alloy implants coated with titanium nitride by a new method

McNicholas

Rowley

McGurty

et al. 2000

The Journal of Bone and Joint Surgery

1,633

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A fter cemented total hip arthroplasty (THA) there may be failure at either the cement-stem or the cement-bone interface. This results from the occurrence of abnormally high shear and compressive stresses within the cement and excessive relative micromovement.We therefore evaluated micromovement and stress at the cement-bone and cement-stem interfaces for a titanium and a chromium-cobalt stem. The behaviour of both implants was similar and no substantial differences were found in the size and distribution of micromovement on either interface with respect to the stiffness of the stem.Micromovement was minimal with a cement mantle 3 to 4 mm thick but then increased with greater thickness of the cement. Abnormally high micromovement occurred when the cement was thinner than 2 mm and the stem was made of titanium.The relative decrease in surface roughness augmented slipping but decreased debonding at the cement-bone interface. Shear stress at this site did not vary significantly for the different coefficients of cement-bone friction while compressive and hoop stresses within the cement increased slightly.

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“…In fact, the stress shielding effect is a dominant factor for loosening orthopedic and dental implants in bones due to the quantitative changes in the total bone mass and bone mineral density (BMD). 4,5) These changes are due to the bone functional adaptation for constructing a load bearing structure. 6) To prevent the stress shielding effect and to maintain normal functional adaptation in bone tissue near implants, the material properties and design of shape for implants should be optimized.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Bone Quality near Metallic Implants with and without Lotus-Type Pores for Optimal Biomaterial Design

et al. 2006

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The stress shielding effect often degrades the quality and quantity of bones near implants. Thus, the shape and structure of metallic biomaterials should be optimally designed. A dominant inorganic substance in bones is a biological apatite (BAp) nanocrystal, which basically crystallizes in an anisotropic hexagonal lattice. The BAp c-axis is parallel to elongated collagen fibers. Because the BAp orientation of bones is a possible parameter of bone quality near implants, we used a microbeam X-ray diffractometer system with a beam spot, which had a diameter of 50 or 100 mm, to evaluate the BAp orientation of bones.Two animal models were prepared: (1) a nail model (: 3.0 mm, SUS316L), which was used to understand the stress shielding effect in a rabbit tibial marrow cavity, and (2) a model of a lotus-type porous implant (: 3.4 mm, mean pore diameter: 170 mm, SUS304L), which was used to understand the effect of the unidirectional-elongated pore direction in an anisotropic bone tissue of a beagle mandible. The porous implants were implanted so that the pore direction was parallel or perpendicular to the mesiodistal axis of mandible.For the porous implant model, new bone formation strongly depended on the elongated pore direction and the time after implantation. For example, four weeks after implantation, new bone formed in pores of the implants, but the BAp orientation degree in the new bone was more similar to that in the original bone in the elongated pores parallel to the mesiodistal direction than that in the perpendicular pores. These differences in bone formation inside the parallel and perpendicular pores may be closely related to the anisotropy of original bone tissues such as the orientations of collagen fiber, BAp, and blood vessels. The orientation degree of BAp also changed in the nail model. The stress shielding effect decreased the orientation degree of the BAp c-axis in the tibia along the longitudinal axis.Thus, optimal design of metallic biomaterials such as implant shape, pore size, elongated pore direction, etc., should be based on the anisotropy of the bone microstructure.

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The influence of prosthetic stem stiffness and of a calcar collar on stresses in the proximal end of the femur with a cemented femoral component.

Cited by 143 publications

References 0 publications

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

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

Osseointegration of Ti6Al4V alloy implants coated with titanium nitride by a new method

Evaluation of Bone Quality near Metallic Implants with and without Lotus-Type Pores for Optimal Biomaterial Design

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