A Mechanical Analysis of Femoral Resurfacing Implantation for Osteonecrosis of the Femoral Head
Section snippets
Materials and Methods
A solid model of a femur was generated from computed tomography (CT) scans (Light Speed Ultra16; GE Medical Systems, Tokyo) of a normal hip from a 28-year-old Japanese woman. For each CT slice, the outer contour of the femur was defined and lofted to form a 3-dimensional solid model of the femur using MECHANICAL FINDER 2.0 (Research Center of Computational Mechanics Inc, Tokyo). We used the proximal 190-mm compartment of the femur. The femur was then virtually implanted with a suitably sized
Result
Expanding the necrosis area, which was replaced by cement, altered the strain distribution within the femoral head. As can be seen Fig. 4, which presents coronal plane sections of each model, strain concentration was not observed in the “type A” femoral head. However, in the “type B” and “type C” femoral heads, we see increased strain near the bone and cement interface corresponding to the expansion of the necrosis replaced by a cement mantle. The strain concentration is particularly evident in
Discussion
Early hip resurfacing implants suffered from poor manufacturing quality of the bearing surface and materials. However, the current generation of metal-on-metal resurfacing arthroplasty, using improved manufacturing techniques, has shown promising results in clinical trials 3, 4, 5. This procedure is regaining its popularity, especially as a treatment option for young and active patients with avascular necrosis of the femoral head, which is difficult to treat with joint preserving surgery (eg,
Conclusions
Finite element analysis of hip resurfacing methods was performed against femoral head necrosis models with various extents of necrosis areas and several implant angles. This study suggests that hip resurfacing for patients in whom osteonecrosis extends widely should be considered very carefully; increased stress concentration near the bone-cement interface may occur when all the necrotic bone is replaced by cement. Further, excessive varus or valgus implantation of the prosthesis has
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Hip resurfacing arthroplasty for osteonecrosis of the femoral head: Implant-specific outcomes and risk factors for failure
2020, Journal of Orthopaedic TranslationCitation Excerpt :In such a condition, substantial amount of the weight-bearing portion in the femoral head has to be replaced by acrylic cement. Sakagoshi et al. [34] revealed that the extent of cement replacing the defect correlates with the strain at the bone–cement interface. To the best of our knowledge, no study has reported the upper threshold regarding the extent of ONFH safe for HRA.
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2017, Journal of Orthopaedic TranslationCitation Excerpt :Additionally, sensitivity of bone scintigraphy is similar to MRI, but its specificity is low. Stress distribution of the necrotic area is a type of finite element analysis, which is based on the development in radiography and takes into account stress distribution analyses [54,55]. Using this method, researchers will simulate the characteristics of various tissues around or in the femoral head by a finite element program, add increasing load gradually on the femoral head, and observe the collapse in the necrotic environment [56,57] (Figure 2).
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2023, Russian Physics Journal
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