Is stem length important in uncemented endoprostheses?

Abstract

In an uncemented total hip replacement where the femoral stem is thinner than the medullary canal it may be hypothesized that the distal portion of the stem has no mechanical function. In this study an uncemented total hip replacement has been modelled mathematically using finite element analysis and mechanical tests of a similar system have been carried out loading implants in cadaveric proximal femora. Two implants have been tested mechanically; one with a full length stem and the second with the stem shortened, but three implants have been modelled with an additional intermediate length stem analysed. Additionally the finite element analysis has been done with a high neck resection and a standard level resection. The finite element model showed that the full length stem produced lower interface contact stress levels under the proximal neck, particularly when the nec was resected, and this was borne out by the mechanical testing.