Restricted accessResearch articleFirst published online 1996-9
Three-dimensional embedded strain gauge analysis of the effect of collared versus collarless prostheses on cement mantle stresses in a femoral model of a total hip replacement
Experimental and finite element analyses have attributed considerable significance to the role of the prosthetic collar in load transfer to the proximal femur; however, some clinical evidence suggests that collar/calcar contact is unnecessary and detrimental. This study investigates the effects of collared versus collarless prostheses on cement mantle stresses in a model analysis of the proximal femur.
Three-dimensional embedded strain gauging is used in a three-times full-size model of an implanted left femur. Tensor stresses in the cement mantle are derived for a collarless Exeter™ stem, a small and a large medial-collared stem and a full-collared prosthesis. Results show that the collar causes an increase in proximal-medial compressive longitudinal stresses, with other proximal stresses significantly reduced. Subsidence of the stem in the cement mantle is prevented, inducing unfavourable pivoting of the prosthesis about the calcar into varus. The collar type produces only minor additional effects in the mechanism of load transfer.
The analysis suggests that collars may inhibit the prosthesis from attaining long-term secondary stability, by preventing the stem subsidence evident with cemented collarless implants. Derived stresses also illustrate the considerable variation in the mechanism of load transfer between collared and collarless prostheses in both the proximal and distal regions.
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