ArticleArchives of orthopaedic and trauma surgery2024
Biomechanical analysis of different THA cementless femoral stem designs in physiological and osteoporotic bone during static loading conditions.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- A comparative meta-analysis of stress shielding between short-stem and conventional femoral stem in total hip arthroplasty.BMC musculoskeletal disorders · 2026Pooled it
- Impact of Femoral Morphology and Stem Design on Intraoperative Periprosthetic Femoral Fractures in Cementless Total Hip Arthroplasty.Journal of clinical medicine · 2026Article
- Biomechanical analysis of surgical alignment and design in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Short Femoral Stem Performance in Femoral Hip Fracture: Clinical and Radiological Evaluation and Comparative Study of Patients Older than 65 Years.Medicina (Kaunas, Lithuania) · 2026Article
- Surgical treatments of metastatic bone disease of the hip joint: a scoping review protocol.BMJ open · 2025Article
- CORR Insights®: Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures?Clinical orthopaedics and related research · 2025Article
- Finite element analysis and its application in Orthopaedics: A narrative review.Journal of clinical orthopaedics and trauma · 2024Review
- What features of stem increase the risk of intraoperative femoral fracture during cementless primary hip arthroplasty?Archives of orthopaedic and trauma surgery · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe influence of THA stem design on periprosthetic femoral fractures (PFFs) risk is subject of debate. This study aims to compare the effects of different cementless stem designs on stress-strain distributions in both physiological and osteoporotic femur under various loading conditions. MATERIALS: A biomechanical study using finite-element analysis was conducted. Four models were developed: three with implanted femurs and a native one chosen as control. Each model was analyzed for both healthy and osteoporotic bone. The following stem designs were examined: short anatomical stem with femoral neck preservation, double-wedge stem, and anatomical standard stem. Three loading conditions were assessed: gait, sideways falling, and four-point bending.
resultsDuring gait in physiological bone, the anatomical stem and the short anatomical stem with femoral neck preservation showed stress distribution similar to the native model. The double-wedge stem reduced stress in the proximal area but concentrated it in the meta-diaphysis. In osteoporotic bone, the double-wedge stem design increased average stress by up to 10%. During sideways falling, the double-wedge stem exhibited higher stresses in osteoporotic bone. No significant differences in average stress were found in any of the studied models during four-point bending.
conclusionIn physiological bone, anatomical stems demonstrated stress distribution comparable to the native model. The double-wedge stem showed uneven stress distribution, which may contribute to long-term stress shielding. In the case of osteoporotic bone, the double-wedge stem design resulted in a significant increase in average stress during both gait and sideways falling, potentially indicating a higher theoretical risk of PFF.
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