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Feng T, Tang H, Zhang X, Zhang Y, Zhou Y, Jin Z. A novel algorithm to efficiently calculate the impingement-free range of motion of irregularly-shaped total hip arthroplasty components. J Orthop Res 2023; 41:2516-2529. [PMID: 37132499 DOI: 10.1002/jor.25585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/04/2023]
Abstract
There is great difficulty in quickly calculating the impingement-free range of motion (IFROM) of hip components with complex shapes after total hip arthroplasty. We have established a new algorithm to investigate the effect of different shapes of hip components on the IFROM and impingement-free safe zone (IFSZ). Then find the best combination of hip prosthesis and the optimal mounting position of the elevated-rim liner under different radiographic anteversion (RA) and radiographic inclination (RI) of the cup. We found the larger the opening angle of the beveled-rim liner and the smaller the cross-sectional area of the stem neck with an inverted teardrop cross-sectional shape, the greater the IFROM of the hip component. The beveled-rim liner in combination with the stem neck with an inverted teardrop-shaped cross-section could provide the greatest IFSZ (excluding the flat-rim liner). The optimal orientation of the elevated-rim liner was the posterior-inferior side (RI ≤ 37°), posterior-superior side (RI ≥ 45°), and posterior side (37° ≤ RI ≤ 45°). Our novel algorithm provides a solution to analyze the IFROM of any hip prosthesis with any complex shape. The shape and size of the cross-section of the stem neck, the orientation of the elevated rim, and the shape and opening angle of the liner are all critical factors for the quantitative calculation of the IFROM and mounting safe zone of the prosthesis. Stem necks with inverted teardrop cross-section and beveled-rim liner improved the IFSZ. The optimal direction of the elevated rim is not constant but varies with RI and RA.
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Affiliation(s)
- Tao Feng
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Hao Tang
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Xiaogang Zhang
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Yali Zhang
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Yixin Zhou
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Zhongmin Jin
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
- School of Mechanical Engineering, University of Leeds, Leeds, UK
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Eslam Pour A, Lazennec JY, Patel KP, Anjaria MP, Beaulé PE, Schwarzkopf R. Femoral stem neck geometry determines hip range of motion shape : a computer simulation study. Bone Joint Res 2021; 10:780-789. [PMID: 34881638 PMCID: PMC8696525 DOI: 10.1302/2046-3758.1012.bjr-2021-0273.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIMS In computer simulations, the shape of the range of motion (ROM) of a stem with a cylindrical neck design will be a perfect cone. However, many modern stems have rectangular/oval-shaped necks. We hypothesized that the rectangular/oval stem neck will affect the shape of the ROM and the prosthetic impingement. METHODS Total hip arthroplasty (THA) motion while standing and sitting was simulated using a MATLAB model (one stem with a cylindrical neck and one stem with a rectangular neck). The primary predictor was the geometry of the neck (cylindrical vs rectangular) and the main outcome was the shape of ROM based on the prosthetic impingement between the neck and the liner. The secondary outcome was the difference in the ROM provided by each neck geometry and the effect of the pelvic tilt on this ROM. Multiple regression was used to analyze the data. RESULTS The stem with a rectangular neck has increased internal and external rotation with a quatrefoil cross-section compared to a cone in a cylindrical neck. Modification of the cup orientation and pelvic tilt affected the direction of projection of the cone or quatrefoil shape. The mean increase in internal rotation with a rectangular neck was 3.4° (0° to 7.9°; p < 0.001); for external rotation, it was 2.8° (0.5° to 7.8°; p < 0.001). CONCLUSION Our study shows the importance of attention to femoral implant design for the assessment of prosthetic impingement. Any universal mathematical model or computer simulation that ignores each stem's unique neck geometry will provide inaccurate predictions of prosthetic impingement. Cite this article: Bone Joint Res 2021;10(12):780-789.
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Affiliation(s)
- Aidin Eslam Pour
- Department of Orthopaedic Surgery, Yale University, New Haven, Connecticut, USA
| | - Jean Yves Lazennec
- Department of Orthopaedic and Trauma Surgery, Pitié-Salpétrière Hospital Assistance Publique-Hopitaux de Paris, Paris, France
| | - Kunj P Patel
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Manan P Anjaria
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Edgar Beaulé
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Canada
| | - Ran Schwarzkopf
- Department of Orthopaedic Surgery, New York University, New York, New York, USA
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Using nonlinear finite element models to analyse stress distribution during subluxation and torque required for dislocation of newly developed total hip structure after prosthetic impingement. Med Biol Eng Comput 2017; 56:37-47. [DOI: 10.1007/s11517-017-1673-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 06/10/2017] [Indexed: 10/19/2022]
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Ezquerra L, Quilez MP, Pérez MÁ, Albareda J, Seral B. Range of Movement for Impingement and Dislocation Avoidance in Total Hip Replacement Predicted by Finite Element Model. J Med Biol Eng 2017; 37:26-34. [PMID: 28286463 PMCID: PMC5325855 DOI: 10.1007/s40846-016-0210-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/18/2016] [Indexed: 11/25/2022]
Abstract
Dislocation is a serious complication in total hip replacement (THR). An inadequate range of movement (ROM) can lead to impingement of the prosthesis neck on the acetabular cup; furthermore, the initiation of subluxation and dislocation may occur. The objective of this study was to generate a parametric three-dimensional finite element (FE) model capable of predicting the dislocation stability for various positions of the prosthetic head, neck, and cup under various activities. Three femoral head sizes (28, 32, and 36 mm) were simulated. Nine acetabular placement positions (abduction angles of 25°, 40° and 60° combined with anteversion angles of 0°, 15° and 25°) were analyzed. The ROM and maximum resisting moment (RM) until dislocation were evaluated based on the stress distribution in the acetabulum component. The analysis allowed for the definition of a “safe zone” of movement for impingement and dislocation avoidance in THR: an abduction angle of 40°–60° and anteversion angle of 15°–25°. It is especially critical that the anteversion angle does not fall to 10°–15°. The sequence of the RM is a valid parameter for describing dislocation stability in FE studies.
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Affiliation(s)
- Laura Ezquerra
- Department of Orthopaedic Surgery, University Hospital Lozano Blesa, San Juan Bosco, 15, 50009 Saragossa, Spain
- C/El Greco, 150, Urbanización Virgen de la Columna, 50730 El Burgo de Ebro, Saragossa, Spain
| | - María Paz Quilez
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Maria de Luna s/n, Campus Río Ebro, Edificio “Agustín de Betancourt”, 50018 Saragossa, Spain
| | - María Ángeles Pérez
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Maria de Luna s/n, Campus Río Ebro, Edificio “Agustín de Betancourt”, 50018 Saragossa, Spain
| | - Jorge Albareda
- Department of Orthopaedic Surgery, University Hospital Lozano Blesa, San Juan Bosco, 15, 50009 Saragossa, Spain
| | - Belén Seral
- Department of Orthopaedic Surgery, University Hospital Lozano Blesa, San Juan Bosco, 15, 50009 Saragossa, Spain
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Michel A, Nguyen VH, Bosc R, Vayron R, Hernigou P, Naili S, Haiat G. Finite element model of the impaction of a press-fitted acetabular cup. Med Biol Eng Comput 2016; 55:781-791. [PMID: 27491803 DOI: 10.1007/s11517-016-1545-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 07/03/2016] [Indexed: 01/07/2023]
Abstract
Press-fit surgical procedures aim at providing primary stability to acetabular cup (AC) implants. Impact analysis constitutes a powerful approach to retrieve the AC implant insertion properties. The aim of this numerical study was to investigate the dynamic interaction occurring between the hammer, the ancillary and bone tissue during the impact and to assess the potential of impact analysis to retrieve AC implant insertion conditions. A dynamic two-dimensional axisymmetric model was developed to simulate the impaction of the AC implant into bone tissue assuming friction at the bone-implant interface and large deformations. Different values of interference fit (from 0.5 to 2 mm) and impact velocities (from 1 to 2 m.s-1) were considered. For each configuration, the variation of the force applied between the hammer and the ancillary was analyzed and an indicator I was determined based on the impact momentum of the signal. The simulated results are compared to the experiments. The value of the polar gap decreases with the impact velocity and increases with the interference fit. The bone-implant contact area was significantly correlated with the resonance frequency (R 2 = 0.94) and the indicator (R 2 = 0.95). The results show the potential of impact analyses to retrieve the bone-implant contact properties.
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Affiliation(s)
- Adrien Michel
- Université Paris Est, Laboratoire de Modélisation et de Simulation Multi-Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010, Créteil, France
| | - Vu-Hieu Nguyen
- Université Paris Est, Laboratoire de Modélisation et de Simulation Multi-Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010, Créteil, France
| | - Romain Bosc
- Service de Chirurgie Plastique et Reconstructive, Hôpital Henri Mondor AP-HP, CHU Paris 12, Université Paris-Est, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Romain Vayron
- Université Paris Est, Laboratoire de Modélisation et de Simulation Multi-Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010, Créteil, France
| | - Philippe Hernigou
- Service de Chirurgie Orthopédique, Hôpital Henri Mondor AP-HP, CHU Paris 12, Université Paris-Est, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Salah Naili
- Université Paris Est, Laboratoire de Modélisation et de Simulation Multi-Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010, Créteil, France
| | - Guillaume Haiat
- CNRS, Laboratoire de Modélisation et de Simulation Multi‑Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010, Créteil, France.
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC, H3C 1K3, Canada.
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC, H4J 1C5, Canada.
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Lin HC, Chi WM, Ho YJ, Lin CC, Chen JH. Theoretical Analysis of Total Hip Dislocation and Comparison of Hemispherical Cup and Newly Developed Cup. J Med Biol Eng 2015. [DOI: 10.1007/s40846-015-0073-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The sagittal stem alignment and the stem version clearly influence the impingement-free range of motion in total hip arthroplasty: a computer model-based analysis. INTERNATIONAL ORTHOPAEDICS 2015; 40:473-80. [DOI: 10.1007/s00264-015-2845-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
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Quental C, Folgado J, Fernandes PR, Monteiro J. Computational analysis of polyethylene wear in anatomical and reverse shoulder prostheses. Med Biol Eng Comput 2014; 53:111-22. [DOI: 10.1007/s11517-014-1221-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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