Finite Element Analysis of the Multiple Drilling Technique for Early Osteonecrosis of the Femoral Head

Bae, Jeong Hwan; Kwak, Dai-Soon; Park, Kyung Soon; Jeon, Insu

doi:10.1007/s10439-013-0851-1

Cited by 31 publications

(28 citation statements)

References 27 publications

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“…The tenet for core decompression with 10-mm trephines 86, and percutaneous drilling 7,88,89,180,[193][194][195][196] is a reduction in intraosseous hypertension 197 . Favorable outcomes have been associated with hips with symptomatic, precollapse, smaller-sized lesions 196 .…”

Section: Core Decompressionmentioning

confidence: 99%

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

Mont

Cherian

Sierra

et al. 2015

The Journal of Bone and Joint Surgery

454

436

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➤ Although multiple theories have been proposed, no one pathophysiologic mechanism has been identified as the etiology for the development of osteonecrosis of the femoral head. However, the basic mechanism involves impaired circulation to a specific area that ultimately becomes necrotic.➤ A variety of nonoperative treatment regimens have been evaluated for the treatment of precollapse disease, with varying success. Prospective, multicenter, randomized trials are needed to evaluate the efficacy of these regimens in altering the natural history of the disease.➤ Joint-preserving procedures are indicated in the treatment of precollapse disease, with several studies showing successful outcomes at mid-term and long-term follow-up.➤ Studies of total joint arthroplasty, once femoral head collapse is present, have described excellent outcomes at greater than ten years of follow-up, which is a major advance and has led to a paradigm shift in treating these patients.➤ The results of hemiresurfacing and total resurfacing arthroplasty have been suboptimal, and these procedures have restricted indications in patients with osteonecrosis of the femoral head.

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Section: Core Decompressionmentioning

confidence: 99%

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

Mont

Cherian

Sierra

et al. 2015

The Journal of Bone and Joint Surgery

454

436

View full text Add to dashboard Cite

show abstract

“…As the data of osteonecrosis model is from a living patient, it cannot be verified by direct biomechanical experiment. Therefore, we compared the stress value and distribution with related researches [11,29], and the similar results were obtained. Meanwhile, the biomechanical experiments were promoted to verify the models from the side.…”

Section: Discussionmentioning

confidence: 74%

The effect of rotational degree and routine activity on the risk of collapse in transtrochanteric rotational osteotomy for osteonecrosis of the femoral head—a finite element analysis

Xie

Deng

Tan

et al. 2020

Med Biol Eng Comput

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To explore the mechanical mechanism and provide preoperative planning basis for transtrochanteric rotational osteotomy (TRO) procedure, a joint-preserving procedure for osteonecrosis of the femoral head. Eleven TRO finite element femurs with the most common types of necrosis were analyzed under multi-loading conditions. Thereafter, we made a comprehensive evaluation by considering the anatomy characters, daily activities, and risk indicators contain necrosis expansion trend, necrotic blood supply pressure, and the risk of fracture. The risk of fracture (ROF) is the lowest when standing on feet and increases gradually during normal walking and walking upstairs and downstairs. Compared with posterior rotation, rotating forward keeps more elements at low risk. Additionally, the correlation analysis shows it has a strong negative correlation (R 2 = 0.834) with the average modulus of the roof. TRO finally decreased the stress and energy effectively. However, the stress and strain energy arise when rotated posteriorly less than 120°. The comprehensive evaluation observed that rotating forward 90°could reduce the total risks to 64%. TRO is an effective technique to prevent collapse. For the anterior and superior large necrosis, we recommend to rotate forward 60°to 90°(more efficient) or backward 180°. The methodology followed in this study could provide accurate and personalize preoperative planning. Keywords Osteonecrosis of the femoral head . Transtrochanteric rotational osteotomy . Routine activity . Risk of collapse . Finite element analysis Pusheng Xie, Yuping Deng and Jinchuan Tan contributed equally to this work. * Hanbin Ouyang

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“…Cortical bone, cancellous bone, cartilage, and necrotic area were considered to be isotropic linear elastic materials. The material parameters in each structure were taken from following previous studies (Table 1) [23][24][25][26]. The mesh division of the bone structure of the hip joint was established using 10-node modified tetrahedron unit, and where cartilage was established using the hexahedron unit.…”

Section: Methodsmentioning

confidence: 99%

“…For loading conditions, single leg support (midstance phase), corresponded to 30% of the gait cycle as reported previously, was applied [23]. A compressive axial load of 570 N, which accounts for 5/6 of 70 kg body weight, was applied to the nodes of proximal acetabular bone [18,20].…”

Section: Methodsmentioning

confidence: 99%

“…The weight-bearing area of the femoral head is mainly located on the anterolateral side of the femoral head, and the contact area of the femoral head to acetabular was approximately to be circular [22,23]. Therefore, the lateral contact area of the femoral head was emphatically studied, and the data from the same 17 points on the surface of this area in each model were collected for statistical analysis, as shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

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The effect of the necrotic area on the biomechanics of the femoral head - a finite element study

Wen

Hao

Yue

et al. 2020

BMC Musculoskelet Disord

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Background: Femoral head collapse is the key to the progress of osteonecrosis of the femoral head (ONFH), but the causes of collapse are not completely clear. The better understanding of the progress of femoral head collapse will guide the treatment strategy for ONFH patients. The purpose of this study was to evaluate the biomechanical influence of necrosis area on the collapse of the femoral head by finite element analysis. Methods: CT and MRI data from the hip joint of a healthy volunteer were collected to establish a finite element (FE) model of a normal hip. Subsequently, five categories of osteonecrosis FE models were established by using the normal model and computer software according to China-Japan Friendship Hospital (CJFH) classification for ONFH. The CJFH system includes five types based on the size and location of necrosis lesions in the femoral head (type M, C, L1, L2, and L3) and the stage of ONFH. The collapse indices of each model were analyzed by FE method, including the displacement, peak von Mises stress and stress index of the simulated necrotic area as well as the lateral pillar contact area of the femoral head to acetabular. Results: (1) The displacement increments in the simulated necrotic areas of type M, C, L1, L2, and L3 models were 3.75 μm, 8.24 μm, 8.47 μm, 18.42 μm, and 20.44 μm respectively; the peak von Mises stress decrements were 1.50 MPa, 3.74 MPa, 3.73 MPa, 4.91 MPa, and 4.92 MPa respectively; and the stress indices were 0.04, 0.08, 0.08, 0.27, and 0.27 respectively. (2) The displacement increments in the lateral pillar contact areas of five type models were significantly different (P < 0.001) and increased in sequence as follows: 1.93 ± 0.15 μm, 5.74 ± 0.92 μm, 5.84 ± 1.42 μm, 14.50 ± 3.00 μm, and 16.43 ± 3.05 μm. The peak von Mises stress decrements were also significantly different (P < 0.001) and increased in sequence as follows: 0.52 ± 0.30 MPa, 0.55 ± 0.12 MPa, 0.67 ± 0.33 MPa, 4.17 ± 0.59 MPa, and 4.19 ± 0.60 MPa. (3) The collapse indices including the displacement increments and peak von Mises stress decrements of type L2 and L3 models were markedly higher than those of type M, C, and L1 models (P < 0.001). Conclusions: The collapse indices of the femoral heads of type L2 and L3 FE models were significantly higher than those of type M, C, and L1. Different areas of necrosis result in varied impact on the femoral head collapse.

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Finite Element Analysis of the Multiple Drilling Technique for Early Osteonecrosis of the Femoral Head

Cited by 31 publications

References 27 publications

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

The effect of rotational degree and routine activity on the risk of collapse in transtrochanteric rotational osteotomy for osteonecrosis of the femoral head—a finite element analysis

The effect of the necrotic area on the biomechanics of the femoral head - a finite element study

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