ArticleJournal of clinical medicine2023
Risk of Interprosthetic Femur Fracture Is Associated with Implant Spacing-A Biomechanical Study.
Article in Journal of clinical medicine, 2023. 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, 11 citations in OpenAlex.
- From load-bearing to load-sharing: contact-driven transitions in locked plate constructs.Archives of orthopaedic and trauma surgery · 2026Article
- Introducing the Universal Periprosthetic Femur Fracture (UPFF) Classification: All Fractures Femur.Journal of clinical medicine · 2026Article
- [Interprosthetic femoral fractures : Osteosynthesis, megaendoprosthesis, limb salvage?]Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Outcome of surgical fixation of interprosthetic femur fractures: a case series in a district general hospital.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Distal femoral shortening osteotomy for managing irreducible hips during total hip replacement in four dogs with severe luxoid hips.Veterinary surgery : VS · 2025Article
- Retrograde Femoral Lengthening Below a Total Hip Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIpsilateral revision surgeries of total hip or knee arthroplasties due to periprosthetic fractures or implant loosening are becoming more frequent in aging populations. Implants in revision arthroplasty usually require long anchoring stems. Depending on the residual distance between two adjacent knee and hip implants, we assume that the risk of interprosthetic fractures increases with a reduction in the interprosthetic distance. The aim of the current study was to investigate the maximum strain within the femoral shaft between two ipsilateral implants tips.
methodsA simplified physical model consisting of synthetic bone tubes and metallic implant cylinders was constructed and the surface strains were measured using digital image correlation. The strain distribution on the femoral shaft was analyzed in 3-point- and 4-point-bending scenarios. The physical model was transferred to a finite element model to parametrically investigate the effects of the interprosthetic distance and the cortical thickness on maximum strain. Strain patterns for all parametric combinations were compared to the reference strain pattern of the bone without implants.
resultsThe presence of an implant reduced principal strain values but resulted in distinct strain peaks at the locations of the implant tips. A reduced interprosthetic distance and thinner cortices resulted in strain peaks of up to 180% compared to the reference. At low cortical thicknesses, the strain peaks increased exponentially with a decrease in the interprosthetic distance. An increasing cortical thickness reduced the peak strains at the implant tips.
conclusionsA minimum interprosthetic distance of 10 mm seems to be crucial to avoid the accumulation of strain peaks caused by ipsilateral implant tips. Interprosthetic fracture management is more important in patients with reduced bone quality.
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