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Performance of the resurfaced hip. Part 1: the influence of the prosthesis size and positioning on the remodelling and fracture of the femoral neck

Dickinson, Alexander, Taylor, Andrew C. and Browne, Martin (2010) Performance of the resurfaced hip. Part 1: the influence of the prosthesis size and positioning on the remodelling and fracture of the femoral neck Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 224, (3), pp. 427-439. (doi:10.1243/09544119JEIM679). (PMID:20408488).

Record type: Article


Hip resurfacing is an established treatment for osteoarthritis in young active patients. Failure modes include femoral neck fracture and prosthesis loosening, which may be associated with medium-term bone adaptation, including femoral neck narrowing and densification around the prosthesis stem.

Finite element modelling was used to indicate the effects of prosthesis sizing and positioning on the bone remodelling and fracture strength under a range of normal and traumatic loads, with the aim of understanding these failure modes better.

The simulations predicted increased superior femoral neck stress shielding in young patients with small prostheses, which required shortening of the femoral neck to give an acceptable implant–bone interface.

However, with a larger prosthesis, natural femoral head centre recreation in the implanted state was possible; therefore stress shielding was restricted to the prosthesis interior, and its extent was less sensitive to prosthesis orientation. With valgus orientation, the implanted neck strength was, at worst, within 3 per cent of its intact strength.

The study suggests that femoral neck narrowing may be linked to a reduction in the horizontal femoral offset, occurring if the prosthesis is excessively undersized. As such, hip resurfacing should aim to reproduce the natural femoral head centre, and, for valgus prosthesis orientation, to avoid femoral neck fracture.

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Published date: March 2010
Keywords: hip resurfacing, finite element analysis, bone remodelling, neck fracture, prosthesis positioning


Local EPrints ID: 143413
ISSN: 0954-4119
PURE UUID: 218670d6-5a90-4310-a423-f5a97219b629
ORCID for Alexander Dickinson: ORCID iD
ORCID for Martin Browne: ORCID iD

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Date deposited: 12 Apr 2010 08:54
Last modified: 07 Sep 2017 16:38

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Author: Andrew C. Taylor
Author: Martin Browne ORCID iD

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