• Biomaterials and Biomechanics in Bioengineering
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• 제5권1호
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• pp.11-23
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• 2020

Total hip prosthesis is used for the patients who have hip fracture and are unable to recover naturally. To de-sign highly durable prostheses one has to take into account the natural processes occurring in the bone. Finite element analysis is a computer based numerical analysis method which can be used to calculate the response of a model to a set of well-defined boundary conditions. In this paper, the static load analysis is based, by se-lecting the peak load during the stumbling activity. Two different implant materials have been selected to study appropriate material. The results showed the difference of maximum von Misses stress and detected the frac-ture of the femur shaft for different model (Charnley and Osteal) implant with the extended finite element method (XFEM), and after the results of the numerical simulation of XFEM for different was used in deter-mining the stress intensity factors (SIF) to identify the crack behavior implant materials for different crack length. It has been shown that the maximum stress intensity factors were observed in the model of Charnley.

• Structural Engineering and Mechanics
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• 제88권6호
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• pp.583-588
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• 2023

Total hip replacement is a crucial intervention for patients with fractured hips who face challenges in natural recovery. The design of durable prostheses requires a comprehensive understanding of the natural processes occurring in bone. This article focuses on static loading analysis, specifically during stumbling activity, aiming to enhance the longevity of prosthetic implants. Three distinct implants, Charnley, Osteal, and Thompson, were selected for a detailed study to determine the most appropriate model. The results revealed critical insights into the distribution of Von Mises stresses on the components of femoral arthroplasty, including the cement, implant, and cortical bone. Furthermore, the examination of shear stress within the cement emerged as a pivotal aspect for all three implants, playing a crucial role in evaluating the performance and durability of hip prostheses. The conclusions drawn from this study strongly suggest that the Thompson model stands out as the most suitable choice for hip joint implants.

• 대한기계학회논문집A
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• 제24권2호
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• pp.329-337
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• 2000

An investigation has been performed to develop an analysis tool based on a nonlinear beam theory, which can be used to predict the long-term behavior of an artificial hip joint. The nonlinear behav ior of the femur arise from the coupled dependence of the bone density and the mechanical properties on each other. The beam theory together with its numerical algorithm is developed to take into account the nonlinear bone remodeling process of the femur that is long enough to be assumed as a beam. A piecewise linear curve for the bone remodeling rate is used in the bone remodeling theory and the surface area density of bone is modeled as the third order polynomial function of bone density. At each section of the beam, a constant curvature is assumed and the longitudinal strains are also assumed to vary linearly across the section. The Newton-Rhapson iteration method is used to solve the nonlinear equations for each cross section of the bone and a backward method is used to march along the time. The density and the remodeling signal ar, calculated along with time for the various time steps, and the developed beam theory has been verified by comparing with the results of finite element analysis of a remodeling bone with an artificial hip joint of titanium prosthesis subjected to uni-axial loads and pure bending moment. It is concluded that the developed beam theory can be used to predict the long-term behavior of the femur and thus to design the artificial hip prosthesis.

• Hip & pelvis
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• 제35권1호
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• pp.40-46
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• 2023

Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

• Structural Engineering and Mechanics
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• 제57권4호
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• pp.717-731
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• 2016

In orthopedic surgery and more especially in total arthroplastie of hip, the fixing of the implants generally takes place essentially by means of constituted surgical polymer cement. The damage of this materiel led to the fatal rupture and thus loosening of the prosthesis in total hip, the effect of over loading as the case of tripping of the patient during walking is one of the parameters that led to the damage of this binder. From this phenomenon we supposed that a remain of bone is included in the cement implantation. The object of this work is to study the effect of this bony inclusion in the zones where the outside conditions (loads and geometric shapes) can provoke the fracture of the cement and therefore the aseptic lousing of the prosthesis. In this study it was assumed the presence of two bones -type inclusions in this material, one after we analyzed the effect of interaction between these two inclusions damage of damage to this material. One have modeled the damage in the cement around this bone inclusion and estimate the crack length from the damaged cement zone in the acetabulum using the finite element method, for every position of the implant under the extreme effort undergone by the prosthesis. We noted that the most intense stress position is around the sharp corner of the bone fragment and the higher level of damage leads directly the fracture of the total prosthesis of the hip.

• Hip & pelvis
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• 제35권4호
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• pp.277-280
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• 2023

Dislocation after a total hip arthroplasty occurs in approximately 1% of patients; however, the frequency is much higher after revision surgery. To prevent dislocation, use of a larger femoral head is recommended, and a dual mobility femoral head has been introduced. However, reducing the dual mobility femoral head to the acetabular component is difficult in cases involving contracture in the soft tissue around the joint. A 72-year-old male patient who developed a periprosthetic joint infection underwent two-stage revision surgery using MUTARS^®. Two months after the revision, the hip joint became dislocated and manual reduction was attempted; however, dislocation occurred again. During another revision using a dual mobility bearing, the soft tissue around the hip joint was too tight to reduce. The problem was overcome by first repositioning the dual mobility head into the acetabular socket, followed by assembly of the diaphyseal portion of the implant.

• 대한골관절종양학회지
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• 제3권1호
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• pp.18-25
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• 1997

Prosthetic replacement is one of the most common methods of reconstruction after resection of malignant tumor around the knee. Gait analysis provides a relative objective data about the gait function of patients with prosthesis. The purpose of this study was to compare the gait pattern of the patients who underwent limb salvage surgery with prosthesis for distal femur and that of patients with prosthesis for proximal tibia. This study included ten patients (4 males, 6 females, mean age 22.7 years, range 14-36) who underwent a wide resection and Kotz hinged modular reconstruction prosthesis replacement and six normal adult(Control). The site of bone tumor was the distal femur (Group 1) in six patients and proximal tibia (Group 2) in 4 patients. The follow-up period ranged from 15 to 82 months (mean : 33 months). The evaluation consisted of clinical assessment, radiographic assessment, gait analysis using VICON 370 Motion Analysis System. The gait analysis included the linear parameters such as, walking velocity, cadence, step length, stride length, stance time, swing time, single support and double support time and the three-dimensional kinematics (joint rotation angle, velocity of joint rotation) of ankle, knee, hip and pelvis in sagittal, coronal and transverse plane. For the kinetic evaluation, the moment of force (unit: Nm/kg) and power (unit: Watt/kg) of ankle, knee and hip joint in sagittal, coronal and transverse plane. In the linear parameters, cadence, velocity, step time and single support were decreased in both group 1 and group 2 compared with control. Double support decreased in group 2 compared with control significantly(p<.05). In contrast to our hypothesis, there was no significant difference between group 1 and group 2. In Kinematics, we observed significant difference (p<.05) of decreased knee flexion in loading response (G2

• 한국CDE학회논문집
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• 제13권3호
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• pp.200-208
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• 2008

Total Hip Replacement(THR) is a surgical procedure that replaces a diseased hip joint with a prosthesis. A plastic or metal cup forms the socket, and the head of the femur is replaced by a metal ball on a stem placed inside the femur. Due to the various types and shapes of human hip joint of every individual, a selected commercial implant sometimes may not be the best-fit to a patient, or it cannot be applied because of its discrepancy. Hence extracting geometry parameters of hip joint is one of the most crucial processes in designing custom-made implants. This paper describes the framework of a methodology to extract the geometric parameters of the hip joint. The parameters include anatomical axis, femoral head, head offset length, femoral neck, neck shaft angle, anteversion, acetabulum, and canal flare index. The proposed system automatically recommends the size and shape of a custom-made hip implant with respect to the patient's individual anatomy from 3D models of hip structures. The proposed procedure creating these custom-made implants with some typical examples is precisely presented and discussed in this paper.

• 대한의용생체공학회:의공학회지
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• 제14권2호
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• pp.155-162
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• 1993

The human's biomechanical structure keeps an optimal state by adapting the original biomechanical structure according to a change in the physical environment. This phenomenon is believed to be the main cause of loosening of the total hip replacement which is used widely in these days. In this study the bone density change due to artificial hip joint, which is generally believed as bone-remodeling, was investigated by the finite element method. For this, 2-D FEM models with 4 nodal point elements were constructed for intact and implanted cases. The density was calculated by comparing the relative amounts of effective stress for these two cases. In this way, calculated new density values were used in the next step as input values and this procedure repeated until convergence was obtained. Severe density change was detected at the femoral cortex of the proximal-medial side as expected. Moreover, following surprising result was found from this analysis. Titanium alloy prosthesis showed less density change compared to stainless steel prosthesis at earlier stage, however, almost same amount of the density change was detected at final stage. It was also found that other design parameters could not significantly affect its density change.

• 한국CDE학회논문집
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• 제21권4호
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• pp.426-432
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• 2016

Designing a morphologically well-fitted hip implant to a patient anatomy is desirable to improve surgical outcomes since a commercial ready-made hip implant may not well conform to the patient joint. In this study, biomechanical stability of patient-specific hip implants with two different stem lengths was compared and discussed using a 3D finite element analysis (FEA). The FEA results in this study showed that an increase in stem length brings about more the peaked von-Mises stress (PVMS) in the prosthesis and less in the femur. However the decrease in von-Mises stress in the femur causes stress shielding phenomenon that usually leads to considerable bone resorption. Although, in biomechanical stability point of view, this work recommends the use of smaller stems, the length of stem must be determined by considering both the von-Mises stress and the stress-shielding phenomenon.