The influence of contact ratio and its location on the primary stability of cementless total hip arthroplasty: A finite element analysis

Reimeringer, M.; Nuño, Natalia

doi:10.1016/j.jbiomech.2016.02.031

Cited by 20 publications

(14 citation statements)

References 37 publications

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“…• A 50 μm reduced medullary canal in order to create an interference fit to model the press-fit action [18]. Cemented models instead were characterized by: • Stems made of high nitrogen content stainless steel [19]; • A uniform layer of Polymethylmethacrylate (PMMA) of the same shape as the implant, 3 mm thick between the bone and the prosthesis [20].…”

Section: Two-dimensional Model Constructionmentioning

confidence: 99%

Section: Evaluation Of Mechanical Responsementioning

confidence: 99%

“…Three quantities were used to assess the mechanical response of the 2D models: the micromovements at the stem-bone and stem-cement interface [18,28,29], the equivalent strain [14] and the Strain Energy Density (SED) [30]. The first is usually used as an indicator of interfacial failure, aseptic loosening of prosthetic components or bone growth [18,28,29]. More in detail, micromotions of the stem in the bone and cement were evaluated using the tangential (CSLIP) and normal displacements (COPEN) for each node ( n ) in the contact surface according to the following relationship:…”

Section: Evaluation Of Mechanical Responsementioning

confidence: 99%

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DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty

et al. 2022

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Purpose Bone quality, bone density, implant type and patient anatomy are critical factors for the success of Total Hip Arthroplasty. This study aims to develop a patient-specific FE model based on DXA images to optimise preoperative planning and follow-up. Methods Three simulations were carried out for each patient: intact femur, press-fit stem and cemented stem, selecting different prosthesis sizes and types (cemented and cementless). The loads were applied at the centre of the femoral head, whereas constraints were placed on the distal nodes of the femoral shaft to simulate the walking condition. The mechanical response was assessed through micromovements, equivalent strains and strain energy density (SED) calculation. Results Models with press-fit prostheses show an average strain greater than 20% compared to the intact femur and 10% compared to models with cemented prostheses. Femoral average strain ranged from about 600 to about 1500 µstrains depending on the patient BMI, BMD and type of implant. The femoral prosthetic models show the highest strain values in Gruen zones located medio-proximally, and lower strains in the lateral regions, mainly for cemented implants. The SED follows the same trend as the average equivalent strain in the Gruen zones. Conclusion DXA-based FE analysis appeared to be helpful to access bone strain distribution in prosthetic hip depending on patient anatomy, BMD, and the type of implant. The study shows the utility of equivalent strains and strains energy density in predicting bone loss and growth around the prosthesis and the influence of BMD and BMI in the final results.

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Section: Two-dimensional Model Constructionmentioning

confidence: 99%

Section: Evaluation Of Mechanical Responsementioning

confidence: 99%

Section: Evaluation Of Mechanical Responsementioning

confidence: 99%

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DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty

et al. 2022

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“…Intraoperative implant insertion was simulated using an implant-bone interference fit of 50 microns and friction coefficient of 0.4. 20,21 Single-leg stance in a 70 kg person was simulated with a static load of 3 kN applied at a 20° angle to the implant, and abductor muscle load of 1.25 kN applied at a 20° angle to the greater trochanteric insertion. 22 Twisting with a planted foot was simulated by applying a torque of 7 Nm to the implant.…”

Section: Simulation Of Implant Insertion Single-leg Stance and Twisti...mentioning

confidence: 99%

Short single-wedge stems have higher risk of periprosthetic fracture than other cementless stem designs in Dorr type A femurs: a finite element analysis

et al. 2020

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Background: The use of total hip arthroplasty (THA) femoral stems that transmit force in a favourable manner to the femur may minimise periprosthetic fractures. Finite element analysis (FEA) is a computerised method that analyses the effect of forces applied to a structure with complex shape. Our aim was to apply FEA to compare primary THA cementless stem designs and their association with periprosthetic fracture risk. Methods: 3-dimensional (3D) models of a Dorr Type A femur and 5 commonly used primary THA cementless stem designs (short single wedge, standard-length single wedge, modular, double-wedge metaphyseal filling, and cylindrical fully coated) were developed using computed tomography (CT) imaging. Implant insertion, single-leg stance, and twisting with a planted foot were simulated. FEA was performed, and maximum femoral strain along the implant-bone interface recorded. Results: Femoral strain was highest with short single-wedge stem design (0.3850) and lowest with standard-length single-wedge design (0.0520). Location of maximum femoral strain varied by stem design, but not with implant insertion, single-leg stance, or twisting with a planted foot. Strain was as high during implant insertion as with single-leg stance or twisting with a planted foot. Conclusions: Our results suggest the risk of intraoperative and postoperative periprosthetic fracture with THA in a Dorr A femur is highest with short single-wedge stems and lowest with standard-length single-wedge stems. Consideration may be given to minimising the use of short single-wedge stems in THA. Implant-specific sites of highest strain should be carefully inspected for fracture.

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“…This makes this surgical procedure one of the most common orthopedic treatments of our time [ 4 ]. The aim of the surgery is to improve the patient's quality of life by restoring freedom of movement in the affected joint and reducing pain [ 5 ]. Continuous research in the field of hip endoprosthetics has led to innovations in technology, materials science, surgical techniques and methods of fixation and sterilization, which have contributed to increasing the life span of implants.…”

Section: Introductionmentioning

confidence: 99%

Stiffness optimization and reliable design of a hip implant by using the potential of additive manufacturing processes

Risse

Woodcock

Brüggemann³

et al. 2022

BioMed Eng OnLine

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Background Due to the steadily increasing life expectancy of the population, the need for medical aids to maintain the previous quality of life is growing. The basis for independent mobility is a functional locomotor system. The hip joint can be so badly damaged by everyday wear or accelerated by illness that reconstruction by means of endoprostheses is necessary. Results In order to ensure a high quality of life for the patient after this procedure as well as a long service life of the prosthesis, a high-quality design is required, so that many different aspects have to be taken into account when developing prostheses. Long-term medical studies show that the service life and operational safety of a hip prosthesis by best possible adaptation of the stiffness to that of the bone can be increased. The use of additive manufacturing processes enables to specifically change the stiffness of implant structures. Conclusions Reduced implant stiffness leads to an increase in stress in the surrounding bone and thus to a reduction in bone resorption. Numerical methods are used to demonstrate this fact in the hip implant developed. The safety of use is nevertheless ensured by evaluating and taking into account the stresses that occur for critical load cases. These results are a promising basis to enable longer service life of prostheses in the future.

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The influence of contact ratio and its location on the primary stability of cementless total hip arthroplasty: A finite element analysis

Cited by 20 publications

References 37 publications

DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty

DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty

Short single-wedge stems have higher risk of periprosthetic fracture than other cementless stem designs in Dorr type A femurs: a finite element analysis

Stiffness optimization and reliable design of a hip implant by using the potential of additive manufacturing processes

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