Total Hip Arthroplasty Using a Short-Stem Prosthesis: Restoration of Hip Anatomy

Amenábar, Tomás; Marimuthu, Kanniraj; Hawdon, Gabrielle; Gildone, Alessandro; McMahon, Stephen

doi:10.1177/230949901502300121

Cited by 15 publications

(10 citation statements)

References 26 publications

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“…Moreover, all of them are related to long stem implants. In this study, the optimal performance was found using a hip implant with a total length smaller than 120 mm; confirming the potential advantages of the short stems [ 50 ]. For the parameter characterizing the implant length in contact with the bone (D), optimal designs resulted in values smaller than 50%.…”

Section: - Discussionsupporting

confidence: 65%

Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant

et al. 2017

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Today, different implant designs exist in the market; however, there is not a clear understanding of which are the best implant design parameters to achieve mechanical optimal conditions. Therefore, the aim of this project was to investigate if the geometry of a commercial short stem hip prosthesis can be further optimized to reduce stress shielding effects and achieve better short-stemmed implant performance. To reach this aim, the potential of machine learning techniques combined with parametric Finite Element analysis was used. The selected implant geometrical parameters were: total stem length (L), thickness in the lateral (R1) and medial (R2) and the distance between the implant neck and the central stem surface (D). The results show that the total stem length was not the only parameter playing a role in stress shielding. An optimized implant should aim for a decreased stem length and a reduced length of the surface in contact with the bone. The two radiuses that characterize the stem width at the distal cross-section in contact with the bone were less influential in the reduction of stress shielding compared with the other two parameters; but they also play a role where thinner stems present better results.

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Section: - Discussionsupporting

confidence: 65%

Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant

et al. 2017

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“…Aus diesem Grund ist die Weiterentwicklung der minimalinvasiven OP-Techniken mit Muskelerhalt notwendig, dies erfordert jedoch modifizierte und neue Implantate, welche diese OP-Techniken ermöglichen [2 -5]. Der Einsatz der totalen Hüftendoprothese hat sich weiterentwickelt von der ausschließlichen Versorgung geriatrischer Patienten hin zu einem jungen und aktiven Patientengut [3,4,6]. Das Langzeitüberleben der konventionellen Designs ist hinreichend und gut dokumentiert, da jedoch bei den jüngeren Patienten die Wahrscheinlichkeit einer notwendigen Revision ansteigt, ist es zu einer Weiterentwicklung der Langschaftprothesen gekommen [1].…”

Section: Finite Element Analysis and Biomechanical Testing Of The Newunclassified

“…Das Langzeitüberleben der konventionellen Designs ist hinreichend und gut dokumentiert, da jedoch bei den jüngeren Patienten die Wahrscheinlichkeit einer notwendigen Revision ansteigt, ist es zu einer Weiterentwicklung der Langschaftprothesen gekommen [1]. Seit Anfang der 1990er-Jahre werden kürzere Implantate entwickelt, um bei ausreichender biomechanischer Verankerung mehr Knochen für spätere Revisionen zu erhalten [6,7]. Es wurden deshalb die Schäfte laufend modifiziert, wobei die schenkelhalsteilerhaltenden Kurzschaftprothesen einen guten Kompromiss für die minimalinvasive Versorgung darstellen.…”

Section: Finite Element Analysis and Biomechanical Testing Of The Newunclassified

Finite Element Analysis and Biomechanical Testing of the New MiniMIS Short Stem

Trieb

Huber²,

Sonntag

et al. 2019

Z Orthop Unfall

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Introduction In hip arthroplasty a trend towards short stem prostheses is observed. The aim of this study is to investigate the finite element analysis and biomechanical fatigue performance of a new short stem prosthesis. Methods A finite element analysis was used to simulate the stresses during neck and stem loading according to the ISO standards. Numerical analysis with applied forces of up to 6 kN were performed in the vertical direction on a femoral neck-preserving stem (MiniMIS). During experimental testing, 10 million cycles with a maximum load of 5.34 kN using the worst case of a XL ceramic head (36 mm) were applied. This was followed by a Locati test, where the load was increased until failure of the stem. Results For all stems, stress values below the limits according to the ISO 5832-3 standard (yield strength of 800 N/mm2) were calculated by the finite element analysis. In the biomechanical tests, the total number of 10 million cycles with a maximum load of 5.34 kN was reached in all cases without any visible signs of implant damage. The estimated load to failure after stem testing was 2.16 kN (required by ISO 7206-4: 1.2 kN) and after neck testing > 9.35 kN (required by ISO 7206-6: 5.4 kN). Summary The presented finite element calculation and subsequent biomechanical testing show that the design of this stem meets the essential mechanical requirements given by the ISO and a material failure is not expected in all variants tested under the applied boundary conditions.

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“…Jobb mozgástartományt, jobb funkcionális eredményt, stabilitást és kevesebb kopást eredményez. Ezért a műtét előttivel megegyező, vagy nagyobb offset az ajánlott (1).…”

Section: Bevezetésunclassified

Metaphysealisan rögzülő szárral végzett csípőízületi totál endoprotézis rövid távú eredményei Klinikánkon

Antal¹,

Vermes²,

Than³

2017

MTO

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A szerzők 26, rövid szárú csípőprotézis beültetésével szerzett tapasztalataikról számolnak be. A betegek közül 13 férfit és 9 nőt operáltak. Négy esetben végeztek mindkét oldali protézisbeültetést. Tíz esetben jobb, 16 esetben bal oldali csípőt operáltak. Az átlagos utánkövetési idő 16,5 hónap volt. A Harris Hip Score érték átlaga 56,34-ről 98,92-re, az SF-36 átlaga 89,96-ról 100,69-ra nőtt. Egy esetben volt a közvetlen posztoperatív szakban protézis luxatio, amely konzervatív kezelésre gyógyult. Egy esetben észleltek intraoperatív femur infractiót, amelyet elláttak. Szeptikus szövődmény nem volt. Az utánkövetés során aszeptikus protézislazulást nem észleltek. Több esetben dysplasiás betegeket operáltak, ezért ezek ellátása fokozott figyelmet igényelt. Kulcsszavak: Arthroplastica; Csípőprotézis; Csontállomány; Femur; Protézis szár;H. Antal, Cs. Vermes, P. Than: Short term results of total hip prostheses with metaphyseal stem anchorage at our clinicThe authors report about their experience with 26 short stem hip prostheses. They treated 13 men and 9 women with this implant. Bilateral prosthesis implantation was performed in 4 cases. They operated 10 left and 16 right hips. The follow-up period was 16.5 months on the average. The average Harris Hip Score increased from 56.34 to 98.92 and the average SF-36 from 89.96 to 100.69. There was one prosthesis dislocation in the immediate postoperative period which was treated in a conservative manner. Intra-operative femur crack occurred in one case which was treated surgically at the same time. There was neither septic complication, nor aseptic loosening during the follow-up period. Patients with dysplastic hips were operated on in several cases, which required special attention.

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Total Hip Arthroplasty Using a Short-Stem Prosthesis: Restoration of Hip Anatomy

Cited by 15 publications

References 26 publications

Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant

Machine learning techniques for the optimization of joint replacements: Application to a short-stem hip implant

Finite Element Analysis and Biomechanical Testing of the New MiniMIS Short Stem

Metaphysealisan rögzülő szárral végzett csípőízületi totál endoprotézis rövid távú eredményei Klinikánkon

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