Abstract
The biomechanical performance of hip prostheses is often suboptimal, which leads to problems such as strain shielding, bone resorption and implant loosening, affecting the long-term viability of these implants for articular repair. Different studies have highlighted the interest of short stems for preserving bone stock and minimizing shielding, hence providing an alternative to conventional hip prostheses with long stems. Such short stems are especially valuable for younger patients, as they may require additional surgical interventions and replacements in the future, for which the preservation of bone stock is fundamental. Arguably, enhanced results may be achieved by combining the benefits of short stems with the possibilities of personalization, which are now empowered by a wise combination of medical images, computer-aided design and engineering resources and automated manufacturing tools. In this study, an innovative design methodology for custom-made short femoral stems is presented. The design process is enhanced through a novel app employing elliptical adjustment for the quasi-automated CAD modeling of personalized short femoral stems. The proposed methodology is validated by completely developing two personalized short femoral stems, which are evaluated by combining in silico studies (finite element method (FEM) simulations), for quantifying their biomechanical performance, and rapid prototyping, for evaluating implantability.
Highlights
IntroductionKoch’s femoral model, which defines two different sets of stress lines with compressive loads along the medial side and tensile loads on the lateral one, has been used to design stems for total hip replacement (THR)
Hip arthroplasty is a surgical procedure in which the total or partial replacement of the hip joint is performed, using an artificial device, the hip/femoral prosthesis, which is a mechanical implant that replaces the joint primarily for two typical situations: to reduce pain and improve joint mobility due to progressive wear caused by osteoarthritis, or fracture of the femoral neck due to trauma or osteoporosis [1].Koch’s femoral model, which defines two different sets of stress lines with compressive loads along the medial side and tensile loads on the lateral one, has been used to design stems for total hip replacement (THR)
Due to the above advantages, to study the customized stems of GC2, the femur subjected to the ISO force was evaluated by performing the same analysis of geometric case 1 (GC1)
Summary
Koch’s femoral model, which defines two different sets of stress lines with compressive loads along the medial side and tensile loads on the lateral one, has been used to design stems for total hip replacement (THR). It is proven that the cortical bone of the femur is subjected to compressive stresses in normal function, in accordance with its histological characteristics. This rethinking of the mode of load transfer on the entire proximal femur revolutionizes the design requirements of an anatomic cementless femoral implant [2]
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