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<p>Polished tapered femoral stems are widely used in total hip arthroplasty (THA) for their excellent long-term outcomes. However, anatomical mismatches in Asian populations increase the risk of periprosthetic femoral fractures and malalignment. This study evaluated the mechanical properties and radiographic alignment of the VLIAN stem—a cemented, polished, double-tapered stem with a rounded shoulder design developed for Asian femoral anatomy—compared to the Exeter stem. Mechanical testing assessed rotational resistance and stiffness using cobalt-chromium stems cemented into custom jigs and composite femur models. Rotational torque and load-displacement curves were analyzed. For clinical evaluation, 654 Japanese patients undergoing primary cemented THA were retrospectively reviewed: 275 received the Exeter stem (2013–2018) and 379 the VLIAN stem (2018–2023). Radiographs were analyzed for stem alignment, Dorr classification, and femoral neck-shaft angle. Results showed no significant difference in rotational resistance or construct stiffness between designs. Radiographic analysis demonstrated significantly smaller varus angles with the VLIAN stem, particularly in Dorr type C femurs and those with lower neck-shaft angles. These findings suggest that anatomical design modifications, such as a rounded shoulder, improve alignment without compromising mechanical strength. Further studies are needed to evaluate long-term clinical outcomes.</p>

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Impact of anatomical adaptation in cemented femoral stems on mechanical properties and alignment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月13日

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  • Tomohiro Shimizu,
  • Tetsuro Oue,
  • Tatsuhiro Ishijima,
  • Michihiro Fujiwara,
  • Yoshihiro Hasebe,
  • Keita Uetsuki,
  • Norimasa Iwasaki,
  • Daisuke Takahashi

摘要

Polished tapered femoral stems are widely used in total hip arthroplasty (THA) for their excellent long-term outcomes. However, anatomical mismatches in Asian populations increase the risk of periprosthetic femoral fractures and malalignment. This study evaluated the mechanical properties and radiographic alignment of the VLIAN stem—a cemented, polished, double-tapered stem with a rounded shoulder design developed for Asian femoral anatomy—compared to the Exeter stem. Mechanical testing assessed rotational resistance and stiffness using cobalt-chromium stems cemented into custom jigs and composite femur models. Rotational torque and load-displacement curves were analyzed. For clinical evaluation, 654 Japanese patients undergoing primary cemented THA were retrospectively reviewed: 275 received the Exeter stem (2013–2018) and 379 the VLIAN stem (2018–2023). Radiographs were analyzed for stem alignment, Dorr classification, and femoral neck-shaft angle. Results showed no significant difference in rotational resistance or construct stiffness between designs. Radiographic analysis demonstrated significantly smaller varus angles with the VLIAN stem, particularly in Dorr type C femurs and those with lower neck-shaft angles. These findings suggest that anatomical design modifications, such as a rounded shoulder, improve alignment without compromising mechanical strength. Further studies are needed to evaluate long-term clinical outcomes.