Can the metaphyseal anchored Metha short stem safely be revised with a standard CLS stem? A biomechanical analysis
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Short stem total hip arthroplasty (SHA) has gained increasing popularity as it conserves bone stock and is supposed to allow revision with a conventional stem. However, no study has evaluated whether the revision of a SHA with a standard total hip arthroplasty (THA) stem provides sufficient primary stability to allow osseous integration.
A neck preserving SHA (Metha) and a standard THA (CLS) stem were implanted into six composite femurs respectively and dynamically loaded (300–1700 N, 1 Hz). Primary stability was evaluated by three dimensional-micromotions (3D micro motion) at five points of the interface. Then, a revision scenario was created by removing the SHA and using the same CLS stem as a revision implant (CLS-revision group), with subsequent evaluation of the 3D micro motion according to the primary CLS stem.
The 3D micro motion pattern significantly differed in the primary situation between the short and the standard stem. The highest 3D micro motion were registered proximally for the Metha and distally for the CLS stem. Revising the Metha with a CLS stem revealed a bony defect at the calcar. However, the 3D micro motion of the CLS-revision group were not significant higher compared to those of the primary CLS stem.
Our results show, that SHA (Metha) and standard THA (CLS) provide a good primary stability, however with different pattern of anchorage. The CLS stem reached a similar stability in this revision scenario as the CLS in the primary situation, wherefore it can be assumed that in uncomplicated revisions the Metha short stem can safely be revised with a CLS standard stem.
KeywordsMicromotion Initial fixation Anchorage Three dimensional 3D SHA
This study includes parts of the thesis of YS.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
There is no funding source.
This article does not contain any studies with human participants or animals performed by any of the authors.
This article does not contain any studies with human participants wherefore no informed consent had to be obtained from individual participants.
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