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The goal of this study was to quantify cortical strains at the site of expected Vancouver Type\u2010B periprosthetic fracture as a function of bone mineral density, femoral stem material, and fixation method using a series of 29 autopsy\u2010retrieved, clinically asymptomatic hip joints with THA. Periprosthetic bone mineral content and density was assessed using dual\u2010energy X\u2010ray absorptiometry by Gruen Zone. Specimens then underwent combined cyclic axial and torsional loading, increasing incrementally from 100\u2009N and \u00b11\u2009Nm to peaks of 700\u2009N and \u00b15\u2009Nm. All specimens experienced significantly higher strains on the lateral surface than on the anterior surface, indicating that the bending loads in the frontal plane, rather than axial\/torsional loads, had the predominant effect. Multiple significant relationships (<jats:italic>p<\/jats:italic>\u2009=\u20090.04, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were found between predicted periprosthetic strains calculated from radiographic measurements and observed principal strains. Though THA in the present study were in successful clinical service, the produced results indicated that some femurs with rigid cemented or noncemented implants were potentially at high risk for Vancouver Type\u2010B fractures, which may be predicted radiographically.<\/jats:p>","DOI":"10.1002\/jor.25203","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T14:22:38Z","timestamp":1635171758000},"page":"1943-1952","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The insidious risk of periprosthetic fracture in clinically functional total hip arthroplasties: A biomechanical study of willed joints"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-550X","authenticated-orcid":false,"given":"Karren M.","family":"Takamura","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, David Geffen School of Medicine, Los Angeles Orthopaedic Center University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2400-9224","authenticated-orcid":false,"given":"Colin P.","family":"McCarty","sequence":"additional","affiliation":[{"name":"The J. 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