Review and prospect of total hip arthroplasty with collum femoris preserving prosthesis based on lever reconstruction balance theory / 中华骨科杂志

ABSTRACT

Collum femoris preserving (CFP) is a surgical approach that emphasizes bone preservation, which can improve the stress distribution of the proximal femur, especially for young and active patients. Although the conventional CFP prosthesis has excellent short-term and medium-term clinical outcomes, and bone stock preservation is better than traditional total hip arthroplasty, it has not shown a higher prosthetic survival rate, which limits the broad application of CFP prosthesis. Compared with the conventional total hip prosthesis stem, the conventional CFP prosthesis improved the compressive stress transfer mechanism by retaining the femoral neck and moving the reconstruction fulcrum inward, neglecting the mechanical reconstruction of tensile stress transfer. Based on the theory of lever reconstruction balance, the bionic collum femoris preserving (BCFP) stem achieves the medial migration of the fulcrum based on preserving the femoral neck and proximal femoral bone and reconstructs the tension stress transmission mechanism through tension screws to reduce the stress shielding effect and improve the stress distribution. In addition to enhancing the initial stability of the prosthesis, the bionic fixation of the prosthesis is realized. Traditional total hip prosthesis and CFP prosthesis are plagued by long-term complications such as aseptic loosening and periprosthetic fractures. The innovative design of the BCFP prosthesis is expected to break new ground in addressing the longevity of the hip prosthesis.