ArticleScientific reports2019
Anatomic grooved stem mitigates strain shielding compared to established total hip arthroplasty stem designs in finite-element models.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Similar outcome with a new anteverted or a straight standard stem: a randomized study of 72 total hip arthroplasties evaluated with clinical variables, radiostereometry, and DXA up to 2 years.Acta orthopaedica · 2022Trial
- Toward next-generation hip implants: From failure mechanisms to translational design.Journal of orthopaedic translation · 2026Review
- Pathomorphological features of the proximal femur in crowe IV hips and their implication on stem selection during total hip arthroplasty.BMC musculoskeletal disorders · 2025Article
- Effect of different constraining boundary conditions on simulated femoral stresses and strains during gait.Scientific reports · 2024Article
- Debulking of the Femoral Stem in a Primary Total Hip Joint Replacement: A Novel Method to Reduce Stress Shielding.Bioengineering (Basel, Switzerland) · 2024Article
- The Potential of Deep Learning to Advance Clinical Applications of Computational Biomechanics.Bioengineering (Basel, Switzerland) · 2023Review
- Capability of auxetic femoral stems to reduce stress shielding after total hip arthroplasty.Journal of orthopaedic translation · 2023Article
- In Silico Clinical Trials in the Orthopedic Device Industry: From Fantasy to Reality?Annals of biomedical engineering · 2021Article
- Femoral Stems With Porous Lattice Structures: A Review.Frontiers in bioengineering and biotechnology · 2021Review
- The anatomical SP-CL stem demonstrates a non-progressing migration pattern in the first year: a low dose CT-based migration study in 20 patients.Acta orthopaedica · 2020Article
- Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CLJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aseptic loosening remains a major problem for uncemented femoral components in primary total hip arthroplasty (THA). Ideally, bone adaptation after THA manifests minimally and local bone density reduction is widely avoided. Different design features may help to approximate initial, post-THA bone strain to levels pre-THA. Strain-shielding effects of different SP-CL stem design features are systematically analyzed and compared to CLS Spotorno and CORAIL using finite element models and physiological musculoskeletal loading conditions. All designs show substantial proximal strain-shielding: 50% reduced medial surface strain, 40-50% reduction at lateral surface, >120 µm/m root mean square error (RMSE) compared to intact bone in Gruen zone 1 and >60 µm/m RMSE in Gruen zones 2, 6, and 7. Geometrical changes (ribs, grooves, cross sections, stem length, anatomic curvature) have a considerable effect on strain-shielding; up to 20%. Combinations of reduced stem stiffness with larger proximal contact area (anatomically curved, grooves) lead to less strain-shielding compared to clinically established implant designs. We found that only the combination of a structurally flexible stem with anatomical curvature and grooves improves strain-shielding compared to other designs. The clinical implications in vivo of this initial strain-shielding difference are currently under evaluation in an ongoing clinical analysis.
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