ArticleJournal of orthopaedic surgery and research2022
Stress distributions of the short stem and the tapered wedge stem at different alignments: a finite element analysis study.
Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Comparison of Periprosthetic Femoral Bone Remodeling After Total Hip Arthroplasty with Zimmer VerSys Taper Stem or VerSys Midcoat Stem: Long-Term Outcomes.Journal of clinical medicine · 2026Article
- Mechanical Effects of Offset and Length of the Cementless Stem for Initial Fixation to the Femur.Clinics in orthopedic surgery · 2025Article
- Comparison of Early Postoperative Stress Distribution around Short and Tapered Wedge Stems in Femurs with Different Femoral Marrow Cavity Geometries Using Finite Element Analysis.Clinics in orthopedic surgery · 2024Article
- Finite element analysis of mechanical stress in a cementless tapered-wedge short stem in the varus position.Journal of orthopaedic surgery and research · 2024Article
- Stem Alignment With the Tapered Wedge Cementless Stem "Accolade II" Does Not Affect Bone Mineral Density Over 5 Years After Total Hip Arthroplasty.Arthroplasty today · 2024Article
- Revision of Failed Short Stems in Total Hip Arthroplasty.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe mechanical effects of stem length reduction and stem alignment on the surrounding femur remain unknown. This study directly compared the stress distribution on the surrounding femur of existing tapered wedge stems and short stems and examined the properties of stress distribution at different stem alignments in three dimensions.
methodsFinite element analysis was conducted for standing and walking. The cementless stem was appropriately sized to ensure adequate contact with the medial cortical bone line that contours the medullary cavity. The stem neck axis was aligned with the femoral neck axis in the mid-position and placed in 2° of the varus and valgus, 3° of flexion and extension, and 10° and 40° of anteversion.
resultsRegardless of stem length, the trend of stress distribution was similar. The short stem generated less stress around the stem than the tapered wedge stem. In the coronal plane, the effect of varus and valgus deflection was small. In the sagittal plane, the stress generated around the stem was higher in the extended position than in the flexed position. In the horizontal plane, the stress generated around the stem was higher when the stem anteversion was smaller.
conclusionsDepending on the design, short stems can reduce the stress on the surrounding bone, compared to a longer tapered wedge with similar stress distribution. Additionally, a short stem can reduce the effect of the varus position. Stems should be placed to achieve stable initial fixation while noting that stresses increase with extension and reduced anteversion.
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