Wear Risk Prevention and Reduction in Total Hip Arthroplasty. A Personalized Study Comparing Cement and Cementless Fixation Techniques Employing Finite Element Analysis

Abstract

The wear rate on Total Hip Arthroplasty (THA) entails a heavy burden for patients. This becomes more relevant with increased wear risk and its consequences such as osteolysis. In addition, osteolysis has been described in cemented and uncemented acetabular implants, and nowadays, controversy remains as to whether or not to cement the acetabular component. A personalized theoretical study was carried out to investigate which parameters have an influence on wear risk and to determine the best fixation method. Liner wear risk was assessed for two different types of fixation (cemented vs uncemented) through Finite Elements Analysis (FEA). The intraoperative variables used to determine the wear risk (cervical-diaphyseal angle, Center of Rotation positioning -COR-, head material, head size, and liner thickness) are vital parameters in surgical planning. Two types of tridimensional liner models of Ultra High Molecular Weight Polyethene (UHMWPE) were simulated through finite element analysis (FEA—over 216 cases were the core of this research). A significant relationship was found between the cervical-diaphyseal angle and wear risk (p < 0.0001), especially in valgus morphology. The acetabular fixation technique (p < 0.0001) and liner thickness (p < 0.0001) showed a significant relationship with wear risk. According to our study, using a cemented fixation with a thick liner in the right center of rotation appears to be the proper stratagy for preventing polyethylene liner wear.

Polycrystalline Diamond as a Potential Material for the Hard-on-Hard Bearing of Total Hip Prosthesis: Von Mises Stress Analysis

“…Next, only femoral head and acetabular cup components are taken into account. In contrast, considering other components, such as pelvic bone and acetabular shell, results in a more realistic modelling scenario [ 59 ]. In terms of the materials assumption, the present finite element model assumes a purely elastic material, without considering plastic behavior on CoCrMo, Al 2 O 3 , and PCD.…”

Finite Element Analysis of Acetabulum Prosthesis’ Lining Damage Zone with Different Implanting Angle

“…Ceramic has good friction, wear, and lubrication properties on the ceramic artificial hip joint, and there is no wear particles and osteolysis after hip prosthesis replacement. The fourth-generation ceramic material has become the preferred femoral head prosthesis material for hip replacement due to its hard texture, biological inertia, and low friction coefficient [13,19,20]. Although the finite element analysis model in this experiment can reflect the stress of the femoral head with different materials on the lining, osteolysis caused by interfacial friction and its induced particles is not considered [21,22].…”

Early unrestricted vs. partial weight bearing after uncemented total hip arthroplasty: a systematic review and meta-analysis

“…Cemented and uncemented prostheses are two choices of fixation for THA. Although cemented THA could provide relatively better prognosis for elderly patients ( 3 ), increasing early loosening rates have been reported ( 4 , 5 ). Besides, younger patients who underwent cemented THA have exhibited higher risk of revision due to more exercise ( 6 ).…”