Diehl K, Harms J
Arch Orthop Unfallchir. 1976 Feb 26;84(1):89-104.
A self-adhesive prosthesis for youth patients is developed by Mittelmeier that is implanted without bone cement. After an implantation term of 1 year in animal experiment (dog), an adapted femur is compared with the contra-lateral normal femur. Strain gauges are used to determine bone strain under load. Further is determined external and internal construction change after endoprosthesis. The construction changes found are in connection with the changed bone strength. A cancellous change of bone at entire area of stem of prosthesis is called a "metaphysation" of bone shaft.