ArticleBone & joint research2019
Short stems have lower load at failure than double-wedged stems in a cadaveric cementless fracture model.
Article in Bone & joint research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- The race for the classification of proximal periprosthetic femoral fractures : Vancouver vs Unified Classification System (UCS) - a systematic review.BMC musculoskeletal disorders · 2022Pooled it
- Mechanical Effects of Offset and Length of the Cementless Stem for Initial Fixation to the Femur.Clinics in orthopedic surgery · 2025Article
- Personalized Stem Length Optimization in Hip Replacement: A Microscopic Perspective on Bone-Implant Interaction.Bioengineering (Basel, Switzerland) · 2024Article
- Comparison of axial-rotational postoperative periprosthetic fracture of the femur in composite osteoporotic femur versus human cadaveric specimens: A validation study.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2022Article
- The impact of reducing the femoral stem length in total hip arthroplasty during gait.Archives of orthopaedic and trauma surgery · 2021Article
- Biomechanics of a cemented short stem: a comparative in vitro study regarding primary stability and maximum fracture load.Archives of orthopaedic and trauma surgery · 2021Article
- Short stem hip arthroplasty via the minimally invasive direct anterior approach.Operative Orthopadie und Traumatologie · 2021Article
- Effect of stem position and length on bone-stem constructs after cementless hip arthroplasty.Bone & joint research · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPeriprosthetic femoral fractures (PFFs) have a higher incidence with cementless stems. The highest incidence among various cementless stem types was observed with double-wedged stems. Short stems have been introduced as a bone-preserving alternative with a higher incidence of PFF in some studies. The purpose of this study was a direct load-to-failure comparison of a double-wedged cementless stem and a short cementless stem in a cadaveric fracture model.
methodsEight hips from four human cadaveric specimens (age mean 76 years (60 to 89)) and eight fourth-generation composite femurs were used. None of the cadaveric specimens had compromised quality (mean T value 0.4 (-1.0 to 5.7)). Each specimen from a pair randomly received either a double-wedged stem or a short stem. A materials testing machine was used for lateral load-to-failure test of up to a maximal load of 5000 N.
resultsMean load at failure of the double-wedged stem was 2540 N (1845 to 2995) and 1867 N (1135 to 2345) for the short stem (p < 0.001). All specimens showed the same fracture pattern, consistent with a Vancouver B2 fracture. The double-wedged stem was able to sustain a higher load than its short-stemmed counterpart in all cases. Failure force was not correlated to the bone mineral density (p = 0.718).
conclusionShort stems have a significantly lower primary load at failure compared with double-wedged stems in both cadaveric and composite specimens. Surgeons should consider this biomechanical property when deciding on the use of short femoral stem.
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