Abstract
Conventional hip arthroplasty femoral stems bypass the femoral neck for fixation.
The femoral neck and proximal femur has a complex anatomy and interosseous structure to facilitate transfer of mechanical load in axial, compression bending and torsion mechanisms.
von Mises analysis suggests a short stem, fixed in the femoral neck would maintain proximal femoral biomechanics, achieve physiological load transfer to the femoral neck and preserve bone stock and function. The strong calcar bone provides excellent opportunities for implant fixation and load transfer.
Method
The Muscle Sparing Arthroplasty (MSA™) is a short femoral stem designed to achieve implant fixation in the femoral neck. The specific design features including a trapezoidal cross section; proximal conical flare; porous coating and lateral T back enhance proximal fixation and compressive load transfer to the calcar and femoral neck.
Results
We report 54 hip arthroplasties in 49 patients with an average follow up of 18 months. All hip arthroplasties showed evidence of new bone formation in the proximal femoral neck and calcar region. This consisted of new bone streaming from the original calcar bone, in a strut fashion up to the conical flare of the implant. In 18 patients additional new bone formation occurred proximal to the neck osteotomy. This pattern of bone formation is consistent with predictions.
Conclusion
A short femoral stem, fixed in the femoral neck can maintain biomechanical function of the femoral neck and result in preservation of bone and new bone stock.
