EFFECTS OF GEOMETRY OF THE INTRAMEDULLARY STEM OF THE ULNA COMPONENT OF HINGED ELBOW JOINT PROSTHESES ON THE BONE AND IMPLANT BENDING STRESSES

Abstract

Cemented intramedullary stems are commonly used in total elbow arthroplasty and a considerable amount of time and money are spent for the design of such devices. In the endeavor of reducing production cost of implants, it is of particular interest as to how the geometry of the intramedullary stem can be altered in order to reduce the amount of raw material used in the manufacture of these components. The main aim of this study was to establish a simple mechanics model in preliminary designing of an elbow joint, so that the effects of the geometry of the intramedullary stem of the ulna component of hinged elbow joint prostheses on the bending stress distribution in the ulna bone and the prosthesis stem during static loading after cemented fixation of the implant can be readily estimated. Two mathematical models, namely (i) linear load transfer model and (ii) beams on elastic foundation model were used. The material considered is biocompatible stainless steel (316L). The locations of maximum bending stress occurrence were identified. Special attention was given toward identifying the locations of stress concentrations as well as the degree of stress shielding expected with various stem geometries. The results were compared to that obtained using well-established finite element analysis techniques and the beams on elastic foundation model were chosen to interpret the stresses. It was found that reducing the length of the intramedullary stem or alternatively tapering the distal end of the stem results in a considerable reduction of stress shielding and renders the bending stress distribution in the bone to be more natural. The use of a tapered stem of rectangular cross section showed a 50% reduction in material usage and a reduction of stress shielding compared to that for a stem of uniform circular cross section. Tapered rectangular sections gave the best results in terms of functionality and cost effectiveness. This observation agrees very well with the rationale of implant design that is practiced over the years. The stresses found using this study can be used for preliminary checks against yield and fracture of the stem material and bone material.