Stress risers between two ipsilateral intramedullary stems: a finite-element and biomechanical analysis

J Arthroplasty. 2005 Apr;20(3):386-91. doi: 10.1016/j.arth.2004.05.002.

Abstract

Periprosthetic fracture after total joint replacement predominantly occurs at the stem tip. In this study, the effects of gap size, stem stability and cortical thickness between two press-fit, ipsilateral intramedullary stems on the tensile stresses created in the femur were investigated using finite-element models. The findings were confirmed with strain-gauge tests using a composite Sawbone femur. Gap size did not affect the level of stress on the femur. Cortical thickness had an important effect on stress distribution: peak stresses increased as bone cortical thickness decreased. Irrespective of gap size, the tips of loose stems acted as stress risers particularly with thinner cortices; the tips of well-fixed stems, however, did not.

MeSH terms

  • Biomechanical Phenomena
  • Chromium Alloys
  • Elasticity
  • Equipment Failure Analysis*
  • Femoral Fractures / physiopathology*
  • Femur / physiopathology
  • Femur / surgery
  • Finite Element Analysis*
  • Fractures, Stress / physiopathology*
  • Hip Prosthesis*
  • Humans
  • Models, Anatomic
  • Postoperative Complications / physiopathology*
  • Prosthesis Design
  • Tensile Strength / physiology

Substances

  • Chromium Alloys