Influence of collars on the primary stability of cementless femoral stems: A finite element study using a diverse patient cohort.

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dc.contributor.author Al-Dirini, Rami MA en
dc.contributor.author Huff, Daniel en
dc.contributor.author Zhang, Ju en
dc.contributor.author Besier, Thor en
dc.contributor.author Clement, John G en
dc.contributor.author Taylor, Mark en
dc.date.accessioned 2018-10-18T23:39:24Z en
dc.date.issued 2018-04 en
dc.identifier.issn 0736-0266 en
dc.identifier.uri http://hdl.handle.net/2292/42896 en
dc.description.abstract For cementless femoral stems, there is debate as to whether a collar enhances primary stability and load transfer compared to collarless designs. Finite Element (FE) analysis has the potential to compare stem designs within the same cohort, allowing for subtle performance differences to be identified, if present. Subject-specific FE models of intact and implanted femora were run for a diverse cohort (21 males, 20 females; BMI 16.4-41.2 kg/m2 , age 50-80 yrs). Collared and collarless versions of Corail® (DePuy Synthes, Warsaw, IN) were sized and positioned using an automated algorithm that aligns the femoral/stem axes, preserves the head-center location, and maximizes metaphyseal fit. Joint contact and muscle forces simulating peak forces in level gait and stair climbing and were scaled to the body mass and applied to each subject. Three failure scenarios were assessed: Potential for peri-prosthetic fibrous tissue formation (stem micromotion), potential for peri-prosthetic bone damage (equivalent strains), and calcar bone remodeling (changes in strain-energy density). Comparisons were performed using paired t-tests. Only subtle differences were found (mean 90th percentile micromotion: Collared = 86 µm, collarless = 92.5 µm, mean 90th percentile interface strains: Collared = 733 µϵ, collarless = 767 µϵ, and similar remodeling stimuli were predicted). The slight differences observed were small in comparison with the inter-patient variability. Statement of clinical significance: Our results suggest that the presence/absence of a collar is unlikely to substantially alter the bone-implant biomechanics nor the initial mechanical environment. Hence, a collar is likely to have minimal clinical impact. Analysis using different femoral stem designs is recommended before generalising these findings. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1185-1195, 2018. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Journal of orthopaedic research : official publication of the Orthopaedic Research Society en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Femur en
dc.subject Humans en
dc.subject Arthroplasty, Replacement, Hip en
dc.subject Cohort Studies en
dc.subject Prosthesis Design en
dc.subject Hip Prosthesis en
dc.subject Finite Element Analysis en
dc.subject Aged en
dc.subject Aged, 80 and over en
dc.subject Middle Aged en
dc.subject Female en
dc.subject Male en
dc.title Influence of collars on the primary stability of cementless femoral stems: A finite element study using a diverse patient cohort. en
dc.type Journal Article en
dc.identifier.doi 10.1002/jor.23744 en
pubs.issue 4 en
pubs.begin-page 1185 en
pubs.volume 36 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 28940776 en
pubs.end-page 1195 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.elements-id 711145 en
pubs.org-id Bioengineering Institute en
pubs.org-id ABI Associates en
dc.identifier.eissn 1554-527X en
pubs.record-created-at-source-date 2017-09-24 en
pubs.dimensions-id 28940776 en


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