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Basic Science
intermediate
X-Type

Stress Shielding in Arthroplasty

Implant Biomechanics

A 65-year-old man presents for routine follow-up 5 years after uncemented total hip arthroplasty. He is asymptomatic with excellent function. Radiographs show excellent stem fixation but notable thinning of the cortical bone in the proximal femur (Gruen zones 1 and 7), particularly in the calcar region. The distal femur around the stem appears maintained. Regarding stress shielding in arthroplasty:

Mark each as TRUE or FALSE

A

Stress shielding is adaptive bone remodeling in response to altered mechanical loading after joint r...

B

Factors affecting stress shielding include implant stiffness (higher elastic modulus relative to bon...

C

Stress shielding only occurs with cemented stems; lower implant stiffness causes more shielding; sma...

D

In total hip arthroplasty, stress shielding manifests as bone loss in Gruen zones 1 (greater trochan...

E

Clinical significance of stress shielding remains debated; while radiographic bone loss is common, i...

Answer the questions to see explanations

Click T (True) or F (False) for each option