Is the strain pattern of conventional stems negatively affected by a previously short stem THA? An experimental study in cadavaric bone

Technol Health Care. 2021;29(2):323-331. doi: 10.3233/THC-191940.

Abstract

Background: A short stem hip arthroplasty can be revised in many cases using a conventional stem. Furthermore, in some cases the implantation of a short stem is intended, but intraoperatively reasons may lead to the decision to implant a conventional stem after previous preparation of a short stem.

Objective: In both cases it is questionable if the anchorage of a conventional stem is negatively affected by the previous preparation of a short stem. In clinical practice mid- or long-term follow up for these special cases hardly exist.

Methods: The strain patterns for the conventional Bicontact stem in primary implantation and after preparation of the proximal femur for a METHA short stem were tested biomechanically in three pairs of cadaveric femora.

Results: The strain patterns for the conventional Bicontact after preparation of the METHA short stem were similar to conditions after testing the conventional stem in primary conditions.

Conclusions: These data lead to the consequence that in clinical practise the implantation of a conventional stem after preparation of a short stem and even after revision of a short stem is possible without increased risk of loosening or long-term stress-shielding.

Keywords: Short stem hip arthroplasty (METHA); biomechanical testing; standard stem hip arthroplasty (Bicontact); strain gauges; strain pattern.

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Femur / surgery
  • Hip Prosthesis*
  • Humans
  • Prosthesis Design