Evidence map›Paper›PMID 36367405›Full record

ArticleSICOT-J2022

Differences between two sequential uncemented stem sizes in total hip arthroplasty: A comparative biomechanical study and potential clinical implications.

Katherine Wang, Eustathios Kenanidis, Khurram Suleman, Mark Miodownik, Mahsa Avadi, David Horne, Jonathan Thompson, Eleftherios Tsiridis, Mehran Moazen

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in SICOT-J, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Katherine WangDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.ORCID 0000-0002-6900-3213
Eustathios KenanidisDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK - Academic Orthopaedic Department, Papageorgiou General Hospital & CORE Lab at CIRI AUTH, Aristotle University Medical School, University Campus, 54 124 Thessaloniki, Greece.
Khurram SulemanDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.
Mark MiodownikDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.
Mahsa AvadiDePuy Synthes, St. Anthony's Road, Leeds LS11 8DT, UK.
David HorneDePuy Synthes, St. Anthony's Road, Leeds LS11 8DT, UK.
Jonathan ThompsonDePuy Synthes, St. Anthony's Road, Leeds LS11 8DT, UK.
Eleftherios TsiridisDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK - Academic Orthopaedic Department, Papageorgiou General Hospital & CORE Lab at CIRI AUTH, Aristotle University Medical School, University Campus, 54 124 Thessaloniki, Greece.
Mehran MoazenDepartment of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.
University College London · GBPapageorgiou General Hospital · GR

Funding

Engineering and Physical Sciences Research Council 539270
6 · The paper itself

Abstract

backgroundEarly failure of uncemented femoral stems associated with incorrect sizing is a known postoperative complication. Surgeons are often faced with the question of whether an uncemented stem of adequate stability or a larger-sized stem should be implanted, especially when the proximal femoral cancellous bone is adequate. The biomechanical effect of sub-optimal stem sizing in the femur remains unclear. This study investigated the mechanical behaviour of two sequential sized uncemented stems of the same type.

methodsSix laboratory models of synthetic non-osteoporotic femora were randomly divided into two groups and implanted with either a nominal or oversized uncemented hydroxyapatite-coated nonporous titanium collarless stem. Stiffness, uniaxial strain, and pattern of strain distribution were measured under an anatomical one-legged stance.

resultsOversized stems demonstrated a higher overall stiffness compared to nominal; however, this was not statistically significant. The nominal stem showed a higher strain in the neck and the proximal medial diaphyseal region. The oversized stem showed higher strains in the distal region around the implant tip.

conclusionOpting to use a larger stem may potentially increase primary stability, thus allowing safer early mobility. However, higher stiffness may lead to stress shielding, bone loss, and thigh pain in the long term. In addition, strains in the diaphysis and the tip of the stem may predispose to periprosthetic fractures, especially in osteoporotic bones, making this a relatable aspect for users and biomechanical loading. Given the wide range of complex factors that need to be considered when choosing stem size in uncemented THA surgery, this study's results should be interpreted cautiously.

Indexed as

BiomechanicsExperimentalStem sizeStiffnessStrainTotal hip arthroplasty (THA)Uncemented

Identifiers

PMID36367405
PMCPMC9651064
OpenAlexW4309242814

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.