• Tomislav Čengić, Janoš Kodvanj, Tomislav Smoljanović, Petra Adamović, Andrija Alerić, Ivan Bohaček, Milan Milošević, Srećko Sabalić, and Domagoj Delimar.
• 1Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia; 3Department of Orthopedic Surgery, Zagreb University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia; 4University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia.
• Acta Clin Croat. 2022 Feb 1; 60 (3): 429-434.

AbstractTotal hip arthroplasty implies proper orientation of both acetabular and femoral components with a range of 25-40° of combined anteversion. The aim of the study was to examine resistance to periprosthetic fracture of the axially loaded cross section rectangular femoral stem (Zweymüller) with respect to different degrees of anteversion, implanted in the artificial bone model, in laboratory conditions. Femoral bone models with implanted femoral stems were divided into 3 groups depending on the degree of stem anteversion (A, control group 13-17°; B, stem retroverted 0°-4°; and C, stem anteverted 26-30°). The amount of axial load leading to periprosthetic fracture (PPFx) of the artificial bone model was determined experimentally for each construct. The results showed that the load at which the PPFx occurred significantly increased with the increase of the endoprosthesis anteversion angle. In our clinical practice, we are often unable to place the acetabular component in an ideal grade of anteversion for intraoperatively determined reasons. The results of this experimental study suggested that increasing rectangular femoral (Zweymüller) stem anteversion lowered the risk of PPFx. This study was limited by experimental design (laboratory conditions, artificial bone) and should be clinically verified.

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