Archives of Orthopaedic and Trauma Surgery

, Volume 129, Issue 6, pp 849–855 | Cite as

Do short-stemmed-prostheses induce periprosthetic fractures earlier than standard hip stems? A biomechanical ex-vivo study of two different stem designs

  • Eike Jakubowitz
  • Jörn B. Seeger
  • Christoph Lee
  • Christian Heisel
  • Jan P. Kretzer
  • Marc N. Thomsen
Basic Science
First Online:
Received:

Abstract

Introduction

The causes of periprosthetic fractures of the femur due to the design of the prosthesis and the individual parameters of the patient are unexplored. By different anchorage techniques in cementless total hip arthroplasties, it is assumed that there are various load limits of the implant’s bearing femur.

Materials and methods

In the present study, we compared a standard hip stem (cementless Spotorno®) and a short-stemmed design (Mayo®) by an artificial reproduction of periprosthetic fractures in 20 femur specimens.

Results

The measured fracture loads showed an extensive range, with higher maximum loads in the standard stem group. The bone mineral density and the subsiding pattern of the standard stems showed a significant correlation to the incidence of the periprosthetic fractures. In the experimental setup, a slightly lower fracture resistance was shown for the short-stemmed prosthesis. Additionally, it was shown that donors with a higher body mass index had a significantly increased fracture risk.

Conclusions

Short-stemmed prostheses, especially the Mayo® hip, do not constitute a higher fracture risk. In general, an increased body mass index among patients with a cementless hip stem is associated with an increased fracture risk, particularly at high load values, i.e., resulting from a step during stumbling. Taking into account the ascertained results, the danger of provoking a femoral periprosthetic fracture can be reduced.

Keywords

Hip joint Arthroplasty Fracture Bone density Biomechanics 
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Notes

Acknowledgments

The authors thank the Ministry of Art and Science of Baden-Württemberg (Germany) for supporting this work with research grants; and PD Dr. Sven Schneider (MA) from the Institute of the German Cancer Research Center for expert advice in statistics.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Eike Jakubowitz
    • 1
  • Jörn B. Seeger
    • 1
    • 2
  • Christoph Lee
    • 1
    • 2
  • Christian Heisel
    • 1
    • 2
  • Jan P. Kretzer
    • 1
  • Marc N. Thomsen
    • 3
  1. 1.Laboratory of Biomechanics and Implant Research, Department of Orthopaedic SurgeryUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of Orthopaedic SurgeryUniversity of HeidelbergHeidelbergGermany
  3. 3.Department of OrthopaedicsGerman Red Cross (DRK) Clinic Baden-BadenBaden-BadenGermany

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