Stresses in cement mantles of hip replacements: effect of femoral implant sizes, body mass index and bone quality

Lamvohee, J.M.S.; Mootanah, Rajshree; Ingle, Paul; Cheah, Kevin; Dowell, John K.

doi:10.1080/10255840902718626

Cited by 10 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that the highest average von Mises stresses occurred in the cortical bone of the superior and anterior periacetabular area of the pelvis. In addition, predictions from our model indicated that pelvic bone stresses are not significantly affected by femoral head implant size, a similar finding to that of Lamvohee et al…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Cement interface and bone stress in total hip arthroplasty: Relationship to head size

Alonso-Rasgado

Del-Valle-Mojica

Jimenez-Cruz

et al. 2018

Journal Orthopaedic Research

View full text Add to dashboard Cite

The use of larger prosthetic femoral heads in total hip arthroplasty (THA) has increased considerably in recent years in response to the need to improve joint stability and reduce risk of dislocation. However, data suggests larger femoral heads are associated with higher joint failure rates. For cemented implants, ensuring the continued integrity of the cement mantle is key to long term fixation. This paper describes an investigation into the effect of variation in femoral head size on stresses in the acetabular cement mantle and pelvic bone. Three commonly used femoral head sizes: 28, 32, and 36 mm diameter were investigated. The study was undertaken using a finite element model validated using surface strains obtained from Digital Image Correlation (DIC) during experimentation on a composite hemipelvis implanted with a cemented all-polyethylene acetabular cup. Following validation, the models were used to investigate stresses in the pelvic bone and acetabular cement mantle resulting from two loading scenarios; an average weight subject (700 N) and an overweight subject (1,000 N) undertaking a single leg stand. We found that the highest peak stresses occurred in the anterosuperior and posterosuperior regions of the bone-cement interface, in the line of action of the load, where debonding usually initiates. Stress on the cortical bone-cement interface increased with femoral head diameter by up to 9% whilst stresses in the trabecular bone remained relatively invariant. Our findings may help to explain higher joint failure rates associated with larger femoral heads. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

show abstract

Section: Discussionsupporting

confidence: 90%

“…The mechanical behavior within the cement mantle and at the bone‐cement interface, where debonding usually initiates, is affected by multiple factors including cement thickness, acetabular cup outer diameter, cup penetration, and inclination angle, bone quality, body mass index and femoral head size …”

mentioning

confidence: 99%

Cement interface and bone stress in total hip arthroplasty: Relationship to head size

Alonso-Rasgado

Del-Valle-Mojica

Jimenez-Cruz

et al. 2018

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…To date, only limited research has been undertaken into determining the effect of femoral head size on the cement mantle stresses. Lamvohee et al, using finite element (FE) modeling, investigated the stresses in the acetabular cement mantle resulting from the use of two femoral head sizes (22 and 28 mm). They found that under the loading condition of normal walking, the tensile stresses in the cement mantle increased by up 27% when femoral head size increased from 22 to 28 mm.…”

mentioning

confidence: 99%

Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

Del‐Valle‐Mojica

Alonso-Rasgado

Jimenez-Cruz

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

In cases where cemented components are used in total hip arthroplasty, damage, or disruption of the cement mantle can lead to aseptic loosening and joint failure. Currently, the relationship between subject activity level, obesity, and prosthetic femoral head size and the risk of aseptic loosening of the acetabular component in cemented total hip arthroplasty is not well understood. This study aims to provide an insight into this. Finite element models, validated with experimental data, were developed to investigate stresses in the acetabular cement mantle and pelvic bone resulting from the use of three prosthetic femoral head sizes, during a variety of daily activities and one high impact activity (stumbling) for a range of subject body weights. We found that stresses in the superior quadrants of the cortical bone-cement interface increased with prosthetic head size, patient weight, and activity level. In stumbling, average von Mises stresses (22.4 MPa) exceeded the bone cement yield strength for an obese subject (143 kg) indicating that the cement mantle would fail. Our results support the view that obesity and activity level are potential risk factors for aseptic loosening of the acetabular component and provide insight into the increased risk of joint failure associated with larger prosthetic femoral heads.

show abstract

“…A wide range of stiffnesses of the equivalent bone was covered by increasing and reducing the elastic modulus of the equivalent bone by 50 per cent, respectively. Although bone quality influences stress distribution in the cement mantle of hip replacement [29], no large differences in the lubrication performance were found in this study for equivalent bones with different elastic moduli, as shown in Fig. 10.…”

Section: Resultsmentioning

confidence: 55%

Elastohydrodynamic lubrication analysis of metal-on-metal hip implants with complex structures using the finite-element method

Meng

Liu

Zhang

2010

Proceedings of the Institution of Mechanical Engineers, Part J:

View full text Add to dashboard Cite

Various complex structures are employed in different metal-on-metal (MOM) hip prostheses for different purposes. For the elastohydrodynamic lubrication (EHL) study of these prostheses, the elastic deformation calculation is not a trivial task due to the effect of complex structures. The finite-element method (FEM) is an attractive approach for solving these problems because of its flexibility in handling complex geometries. Moreover, the availability of high-level ready-to-use finite-element commercial software may facilitate the modelling of complex structures and thereby reduce the time spent on implementing the analysis. In this study, a numerical method was developed to solve the EHL problems of MOM hip prostheses with complex structures. In this method, the elastic deformation was calculated from the product of the flexibility matrix of the lubrication nodes and the nodal force. The flexibility matrix was obtained by inverting the stiffness matrix, which was obtained through finite-element analysis using commercial software. The nodal force was obtained by transferring the hydrodynamic pressure according to the isoparametric element definition. This method was validated for a typical 28 mm diameter MOM total hip replacement. The effects of the structures of the femoral head, the wall thickness of the cup, as well as the bone quality of patients on lubrication performance of MOM hip resurfacing prostheses were subsequently investigated.

show abstract

Stresses in cement mantles of hip replacements: effect of femoral implant sizes, body mass index and bone quality

Cited by 10 publications

References 23 publications

Cement interface and bone stress in total hip arthroplasty: Relationship to head size

Cement interface and bone stress in total hip arthroplasty: Relationship to head size

Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

Elastohydrodynamic lubrication analysis of metal-on-metal hip implants with complex structures using the finite-element method

Contact Info

Product

Resources

About