Journal List > J Korean Orthop Assoc > v.28(4) > 1113805

Park and Park: Clinical Study for the Stress Shielding in Porous coated Femoral Stem

Abstract

Stress shielding is one of the most important problems to be solved in porous coated femoral stem. In case of mild degree, which is one of the remodelling process and shows no clinical problem but in severe degree, poor results can be suspected. The authors reviewed 70 cases of which showed stress shielding after comentless hip replacement arthroplasty using porous coated femoral stem of Harris-Galante type from Jan. 1985 to Dec. 1992. The mean duration of follow up was 30.9 months (range, 12 to 84 months). The correlation between stress shielding and patients age, sex, size of femoral stem, fitness, stability, clinical results and treatment methods were analyzed. The results obtained were as follows: 1. First degree stress shielding found in 37 cases, second degree in 27 cases, third degree in 4 cases and fourth degree in 2 cases according to Enghs classification. 91.4% was mild degree (1st and 2nd degree) and severe degree (3rd and 4th degree) was 8.6%. 2. Below 50 years old group, 27 cases were 1st degree stress shielding, 2nd degree in 12 cases, 3rd degree in 1 case, and above 50 years old group, 10 cases were 1st degree, 2nd degree in 15 cases, 3rd degree in 3 cases and 4th degree in 2 cases. 3. In male, 36 cases were 1st degree stress shielding, 2nd degree in 21 cases, 3rd degree in 2 cases and 4th degree in 1 case. In female, 1 case was 1st degree stress shielding, 2nd degree in 6 cases, 3rd degree in 2 cases and 4th degree in 1 case. 4. Under 13mm sized femoral stem, 22 cases were 1st degree stress shielding, 2nd degree in 21 cases, 3rd degree in 1 case, and in the over 14mm sized femoral stem, 15 cases were 1st degree, 2nd degree 6 cases, 3rd degree in 3 cases and 4th degree in 2 cases. 5. In case of press fit, 33 cases were 1st degree stress shielding, 2nd degree in 26 cases, 3rd degree in 3 cases, and in case of loose-fit, 4 cases were 1st degree, 2nd degree in 1 case, 3rd degree in 1 case and 4th degree in 2 cases. 6. In case of bony ingrowth, 31 cases were 1st degree stress shielding, 2nd degree in 26 cases, 3rd degree in 1 case, and in case of fibrous ingrowth, 6 cases were 1st degree, 2nd degree in 1 case, 3rd degree in 3 cases and 4th degree in 2 cases. 7. There was no significant relationship between degree of stress shielding and preoperative diagnosis, clinical results or treatment methods. 8. Mild degree stress shielding (1st and 2nd degree) occured more commonly in cases of below 50 years old group, male patients, femoral stem under 13mm, bony ingrowth and press fit. 9. Severe degree stress shielding (3rd and 4th degree) occured more commonly in cases obove 50 years old group, female patients, femoral stem over 14mm, fibrous ingrowth, and loose fit.

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