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The specimens were tested under a monotonically increasing cyclic axial loading protocol. Load, cycles, and multiples of the respective body weight at implant loosening was measured. Mean initial stiffness was 2243.9\u2009\u00b1\u2009467.9\u2009N\/mm for the intact group and 2190.1\u2009\u00b1\u2009474.8\u2009N\/mm for the fracture group. Mean load to loosening in the intact group was 3210.5\u2009\u00b1\u20091073.2\u2009N and 2543.6\u2009\u00b1\u2009576.4\u2009N in the fracture group, with statistical significance. Mean cycles to loosening in the intact group were 27104.9\u2009\u00b1\u200910731.7 and 20431.5\u2009\u00b1\u20095763.7 in the fracture group, with statistical significance. Mean multiples of the resulting body weight at loosening in the intact group was 548.3\u2009\u00b1\u2009158.5% and 441.4\u2009\u00b1\u2009104% in the fracture group, with statistical significance. A medial wall defect involving 40% of the medial anchorage distance significantly decreases the axial stability of a diaphyseal anchored stem. However, mechanical failure occurred beyond physiological stress. At loosening rates of about 4 multiples of the body weight in the fracture group, a \u201csafe zone\u201d remains of a 0.5\u2010fold body weight for maximum loads and twofold body weights for average loads.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jor.25406","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T11:39:36Z","timestamp":1655984376000},"page":"641-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cementless femoral stem revision in total hip arthroplasty: The periprosthetic clamshell fracture. 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