TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems
Abstract Background The difference between Young’s moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young’s modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to invest...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01199-z |
| _version_ | 1797784709288165376 |
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| author | Kazuyoshi Baba Yu Mori Daisuke Chiba Yoshiyuki Kuwahara Hiroaki Kurishima Hidetatsu Tanaka Atsushi Kogure Masayuki Kamimura Norikazu Yamada Susumu Ohtsu Masamizu Oyama Naoya Masahashi Shuji Hanada Eiji Itoi Toshimi Aizawa |
| author_facet | Kazuyoshi Baba Yu Mori Daisuke Chiba Yoshiyuki Kuwahara Hiroaki Kurishima Hidetatsu Tanaka Atsushi Kogure Masayuki Kamimura Norikazu Yamada Susumu Ohtsu Masamizu Oyama Naoya Masahashi Shuji Hanada Eiji Itoi Toshimi Aizawa |
| author_sort | Kazuyoshi Baba |
| collection | DOAJ |
| description | Abstract Background The difference between Young’s moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young’s modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems. Methods This study was a clinical trial. Primary THA was performed using a TNS stem from April 2016 to September 2017 for patients in the TNS group. Unilateral THA was performed using a Ti6Al4V alloy stem from January 2007 to February 2011 for patients in the control group. The TNS and Ti6Al4V stems were matched in shape. Radiographs were obtained at the 1- and 3-year follow-ups. Two surgeons independently checked the SS grade and appearance of cortical hypertrophy (CH). The Japanese Orthopaedic Association (JOA) scores before and 1 year after surgery were assessed as clinical scores. Results None of the patients in the TNS group had grade 3 or 4 SS. In contrast, in the control group, 24% and 40% of patients had grade 3 and 4 SS at the 1- and 3-year follow-ups, respectively. The SS grade was lower in the TNS group than in the control group at the 1- and 3-year follow-ups (p < 0.001). The frequencies of CH in both groups were no significant difference at the 1- and 3-year follow-ups. The JOA scores of the TNS group significantly improved at 1 year after surgery and were comparable to control group. Conclusion The TNS stem reduced SS at 1 and 3 years after THA compared to the proximal-engaging cementless stem, although the shapes of the stems matched. The TNS stem could reduce SS, stem loosening, and periprosthetic fractures. Trial registration: Current Controlled Trials. ISRCTN21241251. https://www.isrctn.com/search?q=21241251 . The date of registration was October 26, 2021. Retrospectively registered. |
| first_indexed | 2024-03-13T00:43:44Z |
| format | Article |
| id | doaj.art-988af4c09ea04d68a2704a9bf2be0172 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-13T00:43:44Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-988af4c09ea04d68a2704a9bf2be01722023-07-09T11:09:35ZengBMCEuropean Journal of Medical Research2047-783X2023-07-0128111010.1186/s40001-023-01199-zTiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stemsKazuyoshi Baba0Yu Mori1Daisuke Chiba2Yoshiyuki Kuwahara3Hiroaki Kurishima4Hidetatsu Tanaka5Atsushi Kogure6Masayuki Kamimura7Norikazu Yamada8Susumu Ohtsu9Masamizu Oyama10Naoya Masahashi11Shuji Hanada12Eiji Itoi13Toshimi Aizawa14Department of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Orthopaedic Surgery, Sendai Red Cross HospitalDepartment of Orthopaedic Surgery, Osaki Citizen HospitalDepartment of Orthopaedic Surgery, Sendai Red Cross HospitalInstitute for Materials Research, Tohoku UniversityInstitute for Materials Research, Tohoku UniversityDepartment of Orthopaedic Surgery, Tohoku Rosai HospitalDepartment of Orthopaedic Surgery, Tohoku University School of MedicineAbstract Background The difference between Young’s moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young’s modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems. Methods This study was a clinical trial. Primary THA was performed using a TNS stem from April 2016 to September 2017 for patients in the TNS group. Unilateral THA was performed using a Ti6Al4V alloy stem from January 2007 to February 2011 for patients in the control group. The TNS and Ti6Al4V stems were matched in shape. Radiographs were obtained at the 1- and 3-year follow-ups. Two surgeons independently checked the SS grade and appearance of cortical hypertrophy (CH). The Japanese Orthopaedic Association (JOA) scores before and 1 year after surgery were assessed as clinical scores. Results None of the patients in the TNS group had grade 3 or 4 SS. In contrast, in the control group, 24% and 40% of patients had grade 3 and 4 SS at the 1- and 3-year follow-ups, respectively. The SS grade was lower in the TNS group than in the control group at the 1- and 3-year follow-ups (p < 0.001). The frequencies of CH in both groups were no significant difference at the 1- and 3-year follow-ups. The JOA scores of the TNS group significantly improved at 1 year after surgery and were comparable to control group. Conclusion The TNS stem reduced SS at 1 and 3 years after THA compared to the proximal-engaging cementless stem, although the shapes of the stems matched. The TNS stem could reduce SS, stem loosening, and periprosthetic fractures. Trial registration: Current Controlled Trials. ISRCTN21241251. https://www.isrctn.com/search?q=21241251 . The date of registration was October 26, 2021. Retrospectively registered.https://doi.org/10.1186/s40001-023-01199-zTiNbSn alloyTotal hip arthroplastyStress shieldingLow Young’s modulusFunctionally graded characteristics |
| spellingShingle | Kazuyoshi Baba Yu Mori Daisuke Chiba Yoshiyuki Kuwahara Hiroaki Kurishima Hidetatsu Tanaka Atsushi Kogure Masayuki Kamimura Norikazu Yamada Susumu Ohtsu Masamizu Oyama Naoya Masahashi Shuji Hanada Eiji Itoi Toshimi Aizawa TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems European Journal of Medical Research TiNbSn alloy Total hip arthroplasty Stress shielding Low Young’s modulus Functionally graded characteristics |
| title | TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems |
| title_full | TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems |
| title_fullStr | TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems |
| title_full_unstemmed | TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems |
| title_short | TiNbSn stems with gradient changes of Young’s modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems |
| title_sort | tinbsn stems with gradient changes of young s modulus and stiffness reduce stress shielding compared to the standard fit and fill stems |
| topic | TiNbSn alloy Total hip arthroplasty Stress shielding Low Young’s modulus Functionally graded characteristics |
| url | https://doi.org/10.1186/s40001-023-01199-z |
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