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Updated: Mar 9, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Stem taper mismatch has a critical effect on ceramic head fracture risk in modular hip arthroplasty
Julian Gührs1, Mandy Körner1, Maren Bechstedt1
1TUHH Hamburg University of Technology, Denickestrasse 15, 21073 Hamburg, Germany.
Background:
Modular total hip prostheses with ceramic heads are well established in orthopedic surgery and widely used. With the variety of different manufacturers and available designs, components are at risk for mismatch. Several case studies show the potentially devastating effects of mismatch.
Methods:
The aim of this study was to investigate the outcome of one arbitrary component mismatch with commercially available components that appear to provide a stable fixation during assembly. A biomechanical in-vitro analysis of fracture strength (n=5) was carried out in accordance with ISO 7206-10. "Type1" Bi-Metric®-stems were mismatched with "V40" Al2O3 ceramic heads.
Findings:
Mean fracture strength was reduced to about 50% of the recommended FDA minimum by the mismatch (Mean 23.68kN, SD 2.35kN). A small contact area between head and stem taper was identified as a potential key parameter.
Interpretation:
Mixing and matching components can put a patient at greater risk for ceramic head fracture and must be avoided.
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