Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

被引:16
作者
Del-Valle-Mojica, Jose-Francisco [1 ]
Alonso-Rasgado, Teresa [2 ]
Jimenez-Cruz, David [1 ]
Bailey, Colin G. [2 ]
Board, Tim N. [3 ]
机构
[1] Univ Manchester, Manchester M13 9PL, Lancs, England
[2] Queen Mary Univ London, Sch Engn & Mat Sci, London E1 4NS, England
[3] Wigan & Leigh NHS Fdn Trust, Wrightington Hosp, Wigan WN6 9EP, Lancs, England
关键词
finite element; total hip arthroplasty; femoral head; cement mantle; cemented acetabular cup; BODY-MASS INDEX; MECHANICAL-PROPERTIES; CONTACT MECHANICS; BONE-CEMENT; FIXATION; FAILURE; DISLOCATION; OSTEOLYSIS; REVISION; RISK;
D O I
10.1002/jor.24310
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
In cases where cemented components are used in total hip arthroplasty, damage, or disruption of the cement mantle can lead to aseptic loosening and joint failure. Currently, the relationship between subject activity level, obesity, and prosthetic femoral head size and the risk of aseptic loosening of the acetabular component in cemented total hip arthroplasty is not well understood. This study aims to provide an insight into this. Finite element models, validated with experimental data, were developed to investigate stresses in the acetabular cement mantle and pelvic bone resulting from the use of three prosthetic femoral head sizes, during a variety of daily activities and one high impact activity (stumbling) for a range of subject body weights. We found that stresses in the superior quadrants of the cortical bone-cement interface increased with prosthetic head size, patient weight, and activity level. In stumbling, average von Mises stresses (22.4 MPa) exceeded the bone cement yield strength for an obese subject (143 kg) indicating that the cement mantle would fail. Our results support the view that obesity and activity level are potential risk factors for aseptic loosening of the acetabular component and provide insight into the increased risk of joint failure associated with larger prosthetic femoral heads. (c) 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1771-1783, 2019
引用
收藏
页码:1771 / 1783
页数:13
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