Abstract
Problem statement: There are two types of implant fixation in hip joint replacement-cemented and cementless. The cemented types are, in general, more popular due to concerns of possible inability of cementless implants achieving maximum primary stability for bone integration. The concern is more significant in cases where there are major losses of cancellous bone stock and thinning of the trabeculae due to osteoporosis. Approach: Three Computed Tomography (CT) images of human hip joints were obtained from a hospital. The first patient showed osteoporotic condition based on DEXA scan of the bone. The second was registered for total hip replacement due to significant deterioration of the cartilage covering the bone ends. The third dataset was from a patient with no reported skeletal diseases and was used as control. Three dimensional models of the femora were reconstructed from the CT images and hip arthroplasty using cementless stem was simulated. Finite element method was used to analyze the stability of the implant through a specialized algorithm to measure micromotion at the bone-implant interface. Bone properties were assigned on an element-by element basis and loads simulating stair climbing were used. Results: Hip stems fixed in the control and osteoarthritic femoral model showed minimum interface micromotion. For the osteoporotic bone there is a progressive reduction in surface area feasible for bone in growth. Conclusion/Recommendations: Bone quality affects the stability of femoral components used in hip replacement and therefore the bone-implant integration potential. Cementless hip stem should not be used in patients with osteoporotic condition as the deterioration of bone tissues lead to an increase in interface micromotion.
Highlights
Total replacement of the hip joint is one of the most common procedures in orthopaedic surgery
Interface micromotion would increase as a result and the vicious cycle continues until the implant eventually loosened
There was a large decrease in stiffness in the osteoporotic bone as well as significant reduction in thickness of the cortex compared to the healthy bone
Summary
Total replacement of the hip joint is one of the most common procedures in orthopaedic surgery. Even though the procedure is regarded by many as one of the most successful, complications may still occur postsurgery[1,2,3,4,5,6,7,8]. Loosening of the femoral component is one of the failures associated with thigh pain with revision surgery the only option to relieve pain and regain mobility[9,10,11]. Micromotion at the interface between the implant and the bone is thought to be the reason behind this major complication. Interface micromotion would increase as a result and the vicious cycle continues until the implant eventually loosened
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
