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The influence of resection height on proximal femoral strain patterns after Metha short stem hip arthroplasty: an experimental study on composite femora

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Abstract

Purpose

The number of candidates for a total hip arthroplasty (THA) is steadily increasing, while the average patient age is decreasing for primary THA. The rise in THA is mainly due to excellent clinical outcomes and the extended longevity of modern implants. Short stem arthroplasties with predominantly metaphyseal fixation such as the Metha® stem are suggested for young patients. It is hypothesised that the more physiological load transfer of these devices reduces stress shielding, which in turn may reduce the risk of aseptic loosening. However, patients with femoral deformities often require a deviation of the resection height. To this end, our aim was to evaluate how resection height influences strain patterns in order to characterise possible limits for short stem implantation.

Methods

Biomechanical testing using ten strain gauges on synthetic bone illustrated the strain patterns of three different resection heights (0, +5 and +10 mm) for the Metha stem.

Results

The greatest differences in strains were displayed at the “high” (most proximal) resection height (+10 mm) when compared to the non-implanted strain pattern. At the medial calcar, the strain was 143 % for +10 mm, 96 % for +5 mm and 94 % for 0 mm. Overall, discrepancies were less for deeper resections.

Conclusions

The deeper the resection, the more similar the strain patterns are when compared to a non-implanted synthetic bone. Changes in strain patterns are induced by variation in the varus/valgus positioning of the implant and by different offsets.

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Acknowledgments

The study was kindly supported by the “Hochschulinterne Leistungsförderung (HiLF)” of the MHH and by Aesculap who provided the implants for the biomechanical testing.

Conflict of interest

Three of the authors (T. Floerkemeier, H. Windhagen and G. von Lewinski) are paid instructors for the company B. Braun Aesculap, Tuttlingen, Germany.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany

    Thilo Floerkemeier, Jens Gronewold, Henning Windhagen & Gabriela von Lewinski

  2. Biomechanics and Biomaterials Laboratory of the Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany

    Sebastian Berner, Gavin Olender & Christof Hurschler

Authors
  1. Thilo Floerkemeier
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  2. Jens Gronewold
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  3. Sebastian Berner
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  4. Gavin Olender
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  5. Christof Hurschler
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  6. Henning Windhagen
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  7. Gabriela von Lewinski
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Correspondence to Thilo Floerkemeier.

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Floerkemeier, T., Gronewold, J., Berner, S. et al. The influence of resection height on proximal femoral strain patterns after Metha short stem hip arthroplasty: an experimental study on composite femora. International Orthopaedics (SICOT) 37, 369–377 (2013). https://doi.org/10.1007/s00264-012-1725-0

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  • DOI: https://doi.org/10.1007/s00264-012-1725-0

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