Nonlinear three-dimensional finite element analysis of newly designed cementless total hip stems.

We designed 2 new types of proximally coated stems (the FMS and FMS-anatomic) based on the endosteal geometry of femora with congenital dislocation or dysplastic hip. The FMS was symmetric while the FMS-anatomic was asymmetric. We compared the proximal fit and fill to the femoral canal, contact stress, relative motion, and load transfer to the femur of 5 stems (FMS, FMS-anatomic, Omnifit, Omniflex, and individual stem) using three-dimensional computer simulation and finite element analysis. The FMS and FMS-anatomic showed a significantly greater fit and fill than conventional stems. The dispersion of the contact stresses and reduction of relative motions in the proximal area were the best in the FMS-anatomic compared to other stems with the exception of the individual stem. In addition, the FMS-anatomic stem transferred most of the load to the proximal femur. Our results suggest that the FMS-anatomic should provide better biomechanical stability at least in the early postoperative period.