@article{ref1,
title="Periprosthetic femoral fractures in sideways fall configuration: comparative  numerical analysis of the influence of femoral stem design",
journal="Hip international : the journal of clinical and experimental research on hip pathology and therapy",
year="2020",
author="Franceschini, Massimo and Barbera, Luigi La and Anticonome, Alberto and Ottardi, Claudia and Tanaka, Atsuki and Villa, Tomaso",
volume="30",
number="Suppl 2",
pages="86-93",
abstract="INTRODUCTION: The aim of this study was to investigate the mechanisms of  periprosthetic fractures occurring as a result of a sideways fall in total hip  arthroplasty patients, and to compare the predictions of numerical models in terms  of load distribution on the implanted femur with clinical data.   MATERIALS AND  METHODS: 3 numerical models were built: 1 for intact femur and 2 for implanted femur  with a straight stem (resembling PBF, Permedica) and with an anatomical stem  (resembling ABG II, Stryker). 4 loading configurations were simulated; 1 simulates a  vertical load, and 3 simulate a fall with impact on the greater trochanter in  different directions. Stress state calculated in the implanted femur was compared  for the 2 models with reference to the intact case. These were compared with  clinical data collected at a single centre (Istituto Ortopedico Gaetano Pini, Milan,  Italy) where 41 patients were investigated after periprosthetic fracture: 26  patients had a straight uncemented stem and 15 an anatomical uncemented stem. <br><br>RESULTS: The maximum calculated strain in compression in the case of ABG II  implanted femur was 2 times higher than in the presence of PBF stem in the vertical  loading configuration. For configurations of sideways fall, in both models, there  was a progressive increase of stress state in the bone with increasing angle. Simulations of sideways fall elicited results in accordance with clinical  observations: due to the peculiar stem design and consequent state of stress in the  bone, anatomical stems seem to induce trochanteric fractures more frequently, while  for straight stems type B fractures are more likely to occur. <br><br>CONCLUSIONS: Clinical  findings confirmed numerical model predictions: stem design seems to highly  influence distribution of stress in the bone and consequent localisation of the  fracture site.<p /> <p>Language: en</p>",
language="en",
issn="1120-7000",
doi="10.1177/1120700020971312",
url="http://dx.doi.org/10.1177/1120700020971312"
}