Batailler Cécile, Shatrov Jobe, Schmidt Axel, Servien Elvire, Puch Jean Marc, Lustig Sébastien
Department of Orthopaedic surgery and Sports Medicine, Croix-Rousse Hospital, Lyon University Hospital, 103 grande rue de la Croix Rousse, 69004, Lyon, France - Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 69622 Lyon, France.
Department of Orthopaedic surgery and Sports Medicine, Croix-Rousse Hospital, Lyon University Hospital, 103 grande rue de la Croix Rousse, 69004, Lyon, France - Sydney Orthopaedic Research Institute, University of Notre Dame Australia, Hornsby and Ku-Ring Hospital, NSW 2067, Sydney, Australia.
SICOT J. 2021;7:58. doi: 10.1051/sicotj/2021061. Epub 2021 Nov 19.
The design of uncemented femoral stems for use in total hip arthroplasty has evolved. Several uncemented short stems have been developed with different bone fixations, shapes, or stem lengths. The literature analyzing the biomechanical performance of short to standard stem lengths is limited. The aim was to compare the stress repartition on a standard uncemented stem and a shortened uncemented femoral stem with the same design features.
This finite element analysis assessed the stress repartition on two femoral components with the same design (uncemented, collared, proximal trapezoidal cross-section, and a tapered quadrangular distal stem) but with two different lengths. The shortened stem was shorter by 40 mm compared to the standard stem. The stress repartition was analysed according to the Von Mises criterion.
The stress repartition was similar for the standard and shorter stem without significant difference (p = 0.94). The mean Von Mises stress was 58.1 MPa [0.2; 154.1] for the standard stem and 57.2 MPa [0.03; 160.2] for the short stem. The distal part of the standard stem, which was removed in the short stem, had mean stress of 3.7 MPa [0.2; 7.0].
The finite element analysis found similar stress repartitions between a standard uncemented collared stem and a short, collared stem with the same design. A clinical study assessing the clinical outcomes and the bone remodelling with a collared short stem would be interesting to confirm these first promising results.
用于全髋关节置换术的非骨水泥型股骨柄的设计已经有所发展。已经开发出了几种具有不同骨固定方式、形状或柄长度的非骨水泥短柄。分析短柄至标准柄长度生物力学性能的文献有限。目的是比较具有相同设计特征的标准非骨水泥柄和缩短的非骨水泥股骨柄上的应力分布。
本有限元分析评估了两种具有相同设计（非骨水泥型、带颈圈、近端梯形横截面和渐缩四边形远端柄）但长度不同的股骨部件上的应力分布。缩短后的柄比标准柄短40毫米。根据冯·米塞斯准则分析应力分布。
标准柄和短柄的应力分布相似，无显著差异（p = 0.94）。标准柄的平均冯·米塞斯应力为58.1兆帕[0.2；154.1]，短柄为57.2兆帕[0.03；160.2]。在短柄中被去除的标准柄的远端部分平均应力为3.7兆帕[0.2；7.0]。
有限元分析发现，具有相同设计的标准非骨水泥带颈柄和短带颈柄之间的应力分布相似。进行一项评估带颈短柄临床结果和骨重塑的临床研究，以证实这些初步的良好结果将很有意义。
