Proximal cementation of a collarless polished tapered hip stem: biomechanical analysis using a validated finite element model.

IF 2.6 4区 医学 Q2 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS
Carol Sze Yee Ling, Aiman Izmin, Mitsugu Todo, Azhar M Merican, Desmond Y R Chong
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引用次数: 0

Abstract

Total hip replacement (THR) with cemented stem is a common procedure for patients with hip osteoarthritis. When primary THR fails, removal of the cement is problematic and poses challenges during revision surgeries. The possibility of proximal partial cementing of the hip stem was explored to mitigate the problem. 3D finite element analysis was performed to investigate the feasibility of reduced cement length for effective implant fixation and load transmission. Three levels of cement reduction (40 mm, 80 mm, and 100 mm) in the femoral stem were evaluated. All models were assigned loadings of peak forces acting on the femur during walking and stair climbing. The experimental and predicted max/min principal bone strains were fitted into regression models and showed good correlations. FE results indicated stress increment in the femoral bone, stem, and cement due to cement reduction. A notable increase of bone stress was observed with large cement reduction of 80-100 mm, particularly in Gruen zones 3 and 5 during walking and Gruen zones 3 and 6 during stair climbing. The increase of cement stresses could be limited to 11% with a cement reduction of 40 mm. The findings suggested that a 40-mm cement reduction in hip stem fixation was desirable to avoid unwanted complications after cemented THR.

Abstract Image

无领抛光锥形髋关节柄的近端粘接:利用经过验证的有限元模型进行生物力学分析。
使用骨水泥柄的全髋关节置换术(THR)是髋关节骨性关节炎患者的常见手术。当初次全髋关节置换术失败时,取出骨水泥是个问题,并给翻修手术带来挑战。为缓解这一问题,我们探讨了髋关节柄近端部分骨水泥化的可能性。我们进行了三维有限元分析,以研究缩短骨水泥长度以有效固定植入物和传递载荷的可行性。对股骨柄中三个级别的骨水泥缩减(40 毫米、80 毫米和 100 毫米)进行了评估。所有模型都被赋予了行走和爬楼梯时作用在股骨上的峰值力负荷。实验和预测的最大/最小主骨应变被拟合到回归模型中,并显示出良好的相关性。FE 结果表明,由于骨水泥的减少,股骨头、骨干和骨水泥的应力增加。当骨水泥大量减少 80-100 mm 时,骨应力明显增加,尤其是在行走时的格鲁恩 3 区和 5 区,以及爬楼梯时的格鲁恩 3 区和 6 区。骨水泥减少 40 毫米时,骨水泥应力的增加可限制在 11%。研究结果表明,为避免骨水泥全髋关节置换术后不必要的并发症,髋关节柄固定的骨水泥减薄40毫米是可取的。
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来源期刊
Medical & Biological Engineering & Computing
Medical & Biological Engineering & Computing 医学-工程:生物医学
CiteScore
6.00
自引率
3.10%
发文量
249
审稿时长
3.5 months
期刊介绍: Founded in 1963, Medical & Biological Engineering & Computing (MBEC) continues to serve the biomedical engineering community, covering the entire spectrum of biomedical and clinical engineering. The journal presents exciting and vital experimental and theoretical developments in biomedical science and technology, and reports on advances in computer-based methodologies in these multidisciplinary subjects. The journal also incorporates new and evolving technologies including cellular engineering and molecular imaging. MBEC publishes original research articles as well as reviews and technical notes. Its Rapid Communications category focuses on material of immediate value to the readership, while the Controversies section provides a forum to exchange views on selected issues, stimulating a vigorous and informed debate in this exciting and high profile field. MBEC is an official journal of the International Federation of Medical and Biological Engineering (IFMBE).
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