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Sunavala-Dossabhoy G, Saba BM, McCarthy KJ. Debulking of the Femoral Stem in a Primary Total Hip Joint Replacement: A Novel Method to Reduce Stress Shielding. Bioengineering (Basel) 2024; 11:393. [PMID: 38671814 PMCID: PMC11047840 DOI: 10.3390/bioengineering11040393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
In current-generation designs of total primary hip joint replacement, the prostheses are fabricated from alloys. The modulus of elasticity of the alloy is substantially higher than that of the surrounding bone. This discrepancy plays a role in a phenomenon known as stress shielding, in which the bone bears a reduced proportion of the applied load. Stress shielding has been implicated in aseptic loosening of the implant which, in turn, results in reduction in the in vivo life of the implant. Rigid implants shield surrounding bone from mechanical loading, and the reduction in skeletal stress necessary to maintain bone mass and density results in accelerated bone loss, the forerunner to implant loosening. Femoral stems of various geometries and surface modifications, materials and material distributions, and porous structures have been investigated to achieve mechanical properties of stems closer to those of bone to mitigate stress shielding. For improved load transfer from implant to femur, the proposed study investigated a strategic debulking effort to impart controlled flexibility while retaining sufficient strength and endurance properties. Using an iterative design process, debulked configurations based on an internal skeletal truss framework were evaluated using finite element analysis. The implant models analyzed were solid; hollow, with a proximal hollowed stem; FB-2A, with thin, curved trusses extending from the central spine; and FB-3B and FB-3C, with thick, flat trusses extending from the central spine in a balanced-truss and a hemi-truss configuration, respectively. As outlined in the International Organization for Standardization (ISO) 7206 standards, implants were offset in natural femur for evaluation of load distribution or potted in testing cylinders for fatigue testing. The commonality across all debulked designs was the minimization of proximal stress shielding compared to conventional solid implants. Stem topography can influence performance, and the truss implants with or without the calcar collar were evaluated. Load sharing was equally effective irrespective of the collar; however, the collar was critical to reducing the stresses in the implant. Whether bonded directly to bone or cemented in the femur, the truss stem was effective at limiting stress shielding. However, a localized increase in maximum principal stress at the proximal lateral junction could adversely affect cement integrity. The controlled accommodation of deformation of the implant wall contributes to the load sharing capability of the truss implant, and for a superior biomechanical performance, the collared stem should be implanted in interference fit. Considering the results of all implant designs, the truss implant model FB-3C was the best model.
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Affiliation(s)
- Gulshan Sunavala-Dossabhoy
- Department of Biochemistry and Molecular Biology, LSU Health Science Center in Shreveport and Feist Weiller Cancer Center, Shreveport, LA 71130, USA
| | - Brent M. Saba
- Saba Metallurgical and Plant Engineering Services, LLC, Madisonville, LA 70447, USA;
| | - Kevin J. McCarthy
- Department of Cellular Biology and Anatomy, LSU Health Science Center in Shreveport and Feist Weiller Cancer Center, Shreveport, LA 71130, USA;
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Salaha ZFM, Ammarullah MI, Abdullah NNAA, Aziz AUA, Gan HS, Abdullah AH, Abdul Kadir MR, Ramlee MH. Biomechanical Effects of the Porous Structure of Gyroid and Voronoi Hip Implants: A Finite Element Analysis Using an Experimentally Validated Model. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093298. [PMID: 37176180 PMCID: PMC10179376 DOI: 10.3390/ma16093298] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/12/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Total hip arthroplasty (THA) is most likely one of the most successful surgical procedures in medicine. It is estimated that three in four patients live beyond the first post-operative year, so appropriate surgery is needed to alleviate an otherwise long-standing suboptimal functional level. However, research has shown that during a complete THA procedure, a solid hip implant inserted in the femur can damage the main arterial supply of the cortex and damage the medullary space, leading to cortical bone resorption. Therefore, this study aimed to design a porous hip implant with a focus on providing more space for better osteointegration, improving the medullary revascularisation and blood circulation of patients. Based on a review of the literature, a lightweight implant design was developed by applying topology optimisation and changing the materials of the implant. Gyroid and Voronoi lattice structures and a solid hip implant (as a control) were designed. In total, three designs of hip implants were constructed by using SolidWorks and nTopology software version 2.31. Point loads were applied at the x, y and z-axis to imitate the stance phase condition. The forces represented were x = 320 N, y = -170 N, and z = -2850 N. The materials that were used in this study were titanium alloys. All of the designs were then simulated by using Marc Mentat software version 2020 (MSC Software Corporation, Munich, Germany) via a finite element method. Analysis of the study on topology optimisation demonstrated that the Voronoi lattice structure yielded the lowest von Mises stress and displacement values, at 313.96 MPa and 1.50 mm, respectively, with titanium alloys as the materials. The results also indicate that porous hip implants have the potential to be implemented for hip implant replacement, whereby the mechanical integrity is still preserved. This result will not only help orthopaedic surgeons to justify the design choices, but could also provide new insights for future studies in biomechanics.
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Affiliation(s)
- Zatul Faqihah Mohd Salaha
- Bone Biomechanics Laboratory (BBL), Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
| | - Muhammad Imam Ammarullah
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Pasundan, Bandung 40153, West Java, Indonesia
- Biomechanics and Biomedics Engineering Research Centre, Universitas Pasundan, Bandung 40153, West Java, Indonesia
- Undip Biomechanics Engineering & Research Centre (UBM-ERC), Universitas Diponegoro, Semarang 50275, Central Java, Indonesia
| | - Nik Nur Ain Azrin Abdullah
- Bone Biomechanics Laboratory (BBL), Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
| | - Aishah Umairah Abd Aziz
- Bone Biomechanics Laboratory (BBL), Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
| | - Hong-Seng Gan
- School of AI and Advanced Computing, XJTLU Entrepreneur College (Taicang), Xi'an Jiaotong-Liverpool University, Suzhou 215400, China
| | - Abdul Halim Abdullah
- School of Mechanical Engineering, College of Engineering, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| | - Mohammed Rafiq Abdul Kadir
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
- Medical Devices and Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
| | - Muhammad Hanif Ramlee
- Bone Biomechanics Laboratory (BBL), Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Research Group, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
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Soltanmohammadi P, Tavakoli A, Langohr GDG, Athwal GS, Willing R. Structural analysis of hollow versus solid-stemmed shoulder implants of proximal humeri with different bone qualities. J Orthop Res 2022; 40:674-684. [PMID: 33969537 DOI: 10.1002/jor.25076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 02/04/2023]
Abstract
Stress shielding of the proximal humerus following total shoulder arthroplasty (TSA) can promote unfavorable bone remodeling, especially for osteoporotic patients. The objective of this finite element (FE) study was to determine if a hollow, rather than solid, titanium stem can mitigate this effect for healthy, osteopenic, and osteoporotic bone. Using a population-based model of the humerus, representative average healthy, osteopenic, and osteoporotic humerus FE models were created. For each model, changes in bone and implant stresses following TSA were evaluated for different loading scenarios and compared between solid versus hollow-stemmed implants. For cortical bone, using an implant decreased von Mises stress with respect to intact values up to 34.4%, with a more pronounced effect at more proximal slices. In the most proximal slice, based on changes in strain energy density, hollow-stemmed implants outperformed solid-stemmed ones through reducing cortical bone volume with resorption potential by 11.7% ± 2.1% (p = .01). For cortical bone in this slice, the percentage of bone with resorption potential for the osteoporotic bone was greater than the healthy bone by 8.0% ± 1.4% using the hollow-stemmed implant (p = .04). These results suggest a small improvement in bone-implant mechanics using hollow-stemmed humeral implants and indicate osteoporosis could exacerbate stress shielding to some extent. The hollow stems maintained adequate strength and using even thinner walls may further reduce stress shielding. After further developing these models, future studies could yield optimized implant designs tuned for varying bone qualities.
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Affiliation(s)
| | - Amir Tavakoli
- Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada
| | - G Daniel G Langohr
- School of Biomedical Engineering, Western University, London, Ontario, Canada.,Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada.,Roth, McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada
| | - George S Athwal
- Roth, McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada
| | - Ryan Willing
- School of Biomedical Engineering, Western University, London, Ontario, Canada.,Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada
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Liu B, Wang H, Zhang N, Zhang M, Cheng CK. Femoral Stems With Porous Lattice Structures: A Review. Front Bioeng Biotechnol 2021; 9:772539. [PMID: 34869289 PMCID: PMC8637819 DOI: 10.3389/fbioe.2021.772539] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 01/16/2023] Open
Abstract
Cementless femoral stems are prone to stress shielding of the femoral bone, which is caused by a mismatch in stiffness between the femoral stem and femur. This can cause bone resorption and resultant loosening of the implant. It is possible to reduce the stress shielding by using a femoral stem with porous structures and lower stiffness. A porous structure also provides a secondary function of allowing bone ingrowth, thus improving the long-term stability of the prosthesis. Furthermore, due to the advent of additive manufacturing (AM) technology, it is possible to fabricate femoral stems with internal porous lattices. Several review articles have discussed porous structures, mainly focusing on the geometric design, mechanical properties and influence on bone ingrowth. However, the safety and effectiveness of porous femoral stems depend not only on the characteristic of porous structure but also on the macro design of the femoral stem; for example, the distribution of the porous structure, the stem geometric shape, the material, and the manufacturing process. This review focuses on porous femoral stems, including the porous structure, macro geometric design of the stem, performance evaluation, research methods used for designing and evaluating the femoral stems, materials and manufacturing techniques. In addition, this review will evaluate whether porous femoral stems can reduce stress shielding and increase bone ingrowth, in addition to analyzing their shortcomings and related risks and providing ideas for potential design improvements.
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Affiliation(s)
- Bolun Liu
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Huizhi Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ningze Zhang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Min Zhang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Cheng-Kung Cheng
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Chatterjee S, Roy S, Majumder S, RoyChowdhury A. Biomechanical Analysis to Probe Role of Bone Condition and Subject Weight in Stiffness Customization of Femoral Stem for Improved Periprosthetic Biomechanical Response. J Biomech Eng 2020; 142:101002. [PMID: 32320044 DOI: 10.1115/1.4046973] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Indexed: 11/08/2022]
Abstract
Stress shielding due to difference in stiffness of bone and implant material is one among the foremost causes of loosening and failure of load-bearing implants. Thus far, femoral geometry has been given priority for the customization of total hip joint replacement (THR) implant design. This study, for the first time, demonstrates the key role of bone condition and subject-weight on the customization of stiffness and design of the femoral stem. In particular, internal hollowness was incorporated to reduce the implant stiffness and such designed structure has been customized based on subject parameters, including bone condition and bodyweight. The primary aim was to tailor these parameters to achieve close to natural strain distribution at periprosthetic bone and to reduce interfacial bone loss over time. The maintenance of interfacial bone density over time has been studied here through analysis of bone remodeling (BR). For normal bodyweight, the highest hollowness exhibited clinically relevant biomechanical response, for all bone conditions. However, for heavier subjects, consideration of bone quality was found to be essential as higher hollowness induced bone failure in weaker bones and implant failure in stronger bones. Moreover, for stronger bone, thinner medial wall was found to reduce bone resorption over time on the proximo-lateral zone of stress shielding, while lateral thinning was found advantageous for weaker bones. The findings of this study are likely to facilitate designing of femoral stems for achieving better physiological outcomes and enhancement of the quality of life of patients undergoing THR surgery.
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Affiliation(s)
- Subhomoy Chatterjee
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal 711103, India; Materials Research Centre, Indian Institute of Science, Bangalore, Karnataka 560012, India
| | - Sandipan Roy
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal 711103, India; Department of Mechanical Engineering, SRM Institute of Science & Technology, Kattankulathur, Kancheepuram, Chennai, Tamil Nadu 603203, India
| | - Santanu Majumder
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103, India
| | - Amit RoyChowdhury
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, West Bengal 711103, India
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EBRAHIMZADEH A, JAMSHIDI N. REDUCING STRESS SHIELDING AND WEIGHT AS WELL AS HELPING TO REVASCULARIZATION OF THE FEMUR BY APPLYING HONEYCOMB HOLES IN HIP PROSTHESIS. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419500519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Total hip Arthroplasty is one of the most common surgeries in elderly people around the world. In spite of many successful cases, a few failures are still reported, a significant number of which relates to the effects of stress shielding. Many scientists have been working on solving this problem by enhancing the material and/or the geometry of the hip prostheses’ stems. For example, hollow-stemmed hip prostheses have been designed and tested. In this study, 30 hollow-stemmed samples were designed which were different in terms of geometry and dimension of their holes as well as the materials defined for them. Then, they were tested through finite element modeling along with validating and verifying the results using experimental and convergence tests. The results including displacements, maximum stress values and consequent safety factors were compared based on the reactions of the samples against various static loads including the loads predefined by ISO 7206-4 as well as the loads which had been previously obtained. [Formula: see text]2 designs show the least stiffness compared to other designs. Designs with 132.66[Formula: see text]mm2 hole area are the most promising layouts for reducing weight and providing the most amount of medullary space for revascularization of the femur. In spite of designs which predictably help revascularization more than [Formula: see text]2 designs, these designs which are of the multi-hole patterns seemed to represent the best outcomes in terms of preventing stress shielding and consequently the best pattern for creating holes in the stem according to the precedence of stress shielding over other problems. The results prove the possibility of representing a promising structure which helps to reduce the weight, stress shielding and the lack of revascularization of the femur.
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Affiliation(s)
- A. EBRAHIMZADEH
- Department of Mechanical Engineering, Najafabad Branch, Islamic Azad University, Isfahan, Iran
| | - N. JAMSHIDI
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
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Delikanli YE, Kayacan MC. Design, manufacture, and fatigue analysis of lightweight hip implants. J Appl Biomater Funct Mater 2019; 17:2280800019836830. [DOI: 10.1177/2280800019836830] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yunus E Delikanli
- Senirkent Vocational School, Suleyman Demirel University, Isparta, Turkey
- Senirkent Vocational School, Applied Sciences University of Isparta, Isparta, Turkey
| | - Mehmet C Kayacan
- Department of Mechanical Engineering, Suleyman Demirel University, Isparta, Turkey
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Al-Jassir FF, Fouad H, Alothman OY. In vitro assessment of Function Graded (FG) artificial Hip joint stem in terms of bone/cement stresses: 3D Finite Element (FE) study. Biomed Eng Online 2013; 12:5. [PMID: 23324627 PMCID: PMC3561125 DOI: 10.1186/1475-925x-12-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 01/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stress shielding in the cemented hip prosthesis occurs due to the mismatching in the mechanical properties of metallic stem and bone. This mismatching in properties is considered as one of the main reasons for implant loosening. Therefore, a new stem material in orthopedic surgery is still required. In the present study, 3D finite element modeling is used for evaluating the artificial hip joint stem that is made of Function Graded (FG) material in terms of joint stress distributions and stem length. METHOD 3D finite element models of different stems made of two types of FG materials and traditional stems made of Cobalt Chromium alloy (CoCrMo) and Titanium alloy (Ti) were developed using the ANSYS Code. The effects on the total artificial hip joint stresses (Shear stress and Von Mises stresses at bone cement, Von Mises stresses at bone and stem) due to using the proposed FG materials stems were investigated. The effects on the total artificial hip joint system stresses due to using different stem lengths were investigated. RESULTS Using FG stem (with low stiffness at stem distal end and high stiffness at its proximal end) resulted in a significant reduction in shear stress at the bone cement/stem interface. Also, the Von Mises stresses at the bone cement and stem decrease significantly when using FG material instead of CoCrMo and Ti alloy. The stresses' distribution along the bone cement length when using FG material was found to be more uniform along the whole bone cement compared with other stem materials. These more uniform stresses will help in the reduction of the artificial hip joint loosening rate and improve its short and long term performance. CONCLUSION FE results showed that using FG stem increases the resultant stresses at the femur bone (reduces stress shielding) compared to metallic stem. The results showed that the stem length has significant effects on the resultant shear and Von Mises stresses at bone, stem and bone cement for all types of stem materials.
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Affiliation(s)
- Fawzi F Al-Jassir
- FRCSC, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Orthopedic Surgery Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - H Fouad
- Biomedical Engineering Department, Helwan University, Faculty of Engineering, Helwan, Egypt
| | - Othaman Y Alothman
- Department of Chemical Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
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WANG LIZHEN, ZHAO FENG, HAN JINGYUN, WANG CHAO, FAN YUBO. BIOMECHANICAL STUDY ON PROXIMAL FEMORAL NAIL ANTIROTATION (PFNA) FOR INTERTROCHANTERIC FRACTURE. J MECH MED BIOL 2012. [DOI: 10.1142/s0219519412005125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The proximal femoral nail antirotation device (PFNA) is a typical implant to the treatment of intertrochanteric fractures. However, re-fracture of the femur shaft after nailing are usually been reported. The purpose of this study was to investigate the biomechanical features in the healed proximal femur at different stages in the healing process. Stress and strain distributions, total strain energy density (SED) along the femur and PFNA were analyzed in walking and stair climbing. Results showed remarkable stress concentration occurred near the locking bolt hole with retained PFNA, decreased after PFNA removal. Stair climbing resulted in higher strain at the locking bolt hole than normal walking. The conclusion can be drawn that non-removal of PFNA after healing may result in high fractural risk near locking bolt on femoral shaft. Meanwhile, stair climbing should be avoided during healing.
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Affiliation(s)
- LIZHEN WANG
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
| | - FENG ZHAO
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
| | - JINGYUN HAN
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
| | - CHAO WANG
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
| | - YUBO FAN
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
- National Key Lab of Virtual Reality Technology, Beihang University, 100191 Beijing, China
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Sivarasu S, Beulah P, Mathew L. Novel Approach for Designing a Low Weight Hip Implant Used in Total Hip Arthroplasty Adopting Skeletal Design Techniques. Artif Organs 2011; 35:663-6. [DOI: 10.1111/j.1525-1594.2010.01145.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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