Femoral stress distribution in fully hydroxyapatite-coated cementless versus polished cemented stems with identical geometry: a thermoelastic stress analysis

This simulation study showed that fixation method and material influence short-term femoral stress distribution, even when stem geometry is identical. These findings describe only mechanical behavior under simplified conditions. The use of composite femurs, the one-size difference between stems, and the short-term evaluation limit the generalizability of the results. Further research using cadaveric models and clinical follow-up is required to clarify long-term remodeling and support stem selection in total hip arthroplasty.