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THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses

THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses
THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses
Aseptic loosening of artificial hip joints is believed to be influenced by the design and orientation of the implant. It is hypothesised that variations in implant anteversion and offset lead to changes in the loading of the proximal femur, causing critical conditions to both the bone and cement. The goal of this study was therefore to analyse the role of these parameters on loading, bone strains and cement stresses in total hip arthroplasty (THA). A validated musculo-skeletal model was used for the analysis of muscle and joint contact forces during walking and stair climbing. Two different anteversion angles (4[deg] vs. 24[deg]) and prostheses offsets (standard vs. long) were analysed. The loads for each case were applied to a cemented THA finite element model. Generally, stair climbing caused higher bone strains and cement stresses (max. +25%) than walking. Variations in anteversion and offset caused changes in the loading environment, bone strain distribution and cement stresses. Compared to the standard THA configuration, cement stresses were raised by increasing anteversion (max. +52%), offset (max. +5%) and their combination (max. +67%). Femoral anteversion, offset and their combination may therefore lead to an increased risk of implant loosening. Analyses of implant survival should consider this as a limiting factor in THA longevity. In clinical practice, implant orientation, especially in regard to pre- and post-operative anteversion, should be considered to be more critical.
anteversion, joint geometry, muscle forces, total hip arthroplasty, finite element analysis, total hip-arthroplasty, total joint arthroplasty, component offset finite-element, neck length, follow-up, stem replacement, bone
0736-0266
767-774
Kleemann, Ralf U.
4a23a202-95e4-4f72-bc37-6fea171ba233
Heller, Markus O.
3da19d2a-f34d-4ff1-8a34-9b5a7e695829
Stoeckle, Ulrich
47b257a4-f1cd-440d-8ccd-b33e7e8369be
Taylor, William R.
1ed48ef6-e396-40f5-8434-6c0628c9d3ca
Duda, Georg N.
ac4e207b-3e2e-4c84-a6c4-cb67531f890b
Kleemann, Ralf U.
4a23a202-95e4-4f72-bc37-6fea171ba233
Heller, Markus O.
3da19d2a-f34d-4ff1-8a34-9b5a7e695829
Stoeckle, Ulrich
47b257a4-f1cd-440d-8ccd-b33e7e8369be
Taylor, William R.
1ed48ef6-e396-40f5-8434-6c0628c9d3ca
Duda, Georg N.
ac4e207b-3e2e-4c84-a6c4-cb67531f890b

Kleemann, Ralf U., Heller, Markus O., Stoeckle, Ulrich, Taylor, William R. and Duda, Georg N. (2003) THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses. Journal of Orthopaedic Research, 21 (5), 767-774. (doi:10.1016/S0736-0266(03)00040-8).

Record type: Article

Abstract

Aseptic loosening of artificial hip joints is believed to be influenced by the design and orientation of the implant. It is hypothesised that variations in implant anteversion and offset lead to changes in the loading of the proximal femur, causing critical conditions to both the bone and cement. The goal of this study was therefore to analyse the role of these parameters on loading, bone strains and cement stresses in total hip arthroplasty (THA). A validated musculo-skeletal model was used for the analysis of muscle and joint contact forces during walking and stair climbing. Two different anteversion angles (4[deg] vs. 24[deg]) and prostheses offsets (standard vs. long) were analysed. The loads for each case were applied to a cemented THA finite element model. Generally, stair climbing caused higher bone strains and cement stresses (max. +25%) than walking. Variations in anteversion and offset caused changes in the loading environment, bone strain distribution and cement stresses. Compared to the standard THA configuration, cement stresses were raised by increasing anteversion (max. +52%), offset (max. +5%) and their combination (max. +67%). Femoral anteversion, offset and their combination may therefore lead to an increased risk of implant loosening. Analyses of implant survival should consider this as a limiting factor in THA longevity. In clinical practice, implant orientation, especially in regard to pre- and post-operative anteversion, should be considered to be more critical.

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More information

Published date: September 2003
Keywords: anteversion, joint geometry, muscle forces, total hip arthroplasty, finite element analysis, total hip-arthroplasty, total joint arthroplasty, component offset finite-element, neck length, follow-up, stem replacement, bone
Organisations: Bioengineering Group

Identifiers

Local EPrints ID: 348498
URI: http://eprints.soton.ac.uk/id/eprint/348498
ISSN: 0736-0266
PURE UUID: 5a1de6ef-fb78-41c9-b18e-85ac47288317
ORCID for Markus O. Heller: ORCID iD orcid.org/0000-0002-7879-1135

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Date deposited: 26 Feb 2013 12:28
Last modified: 26 Nov 2019 01:37

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Contributors

Author: Ralf U. Kleemann
Author: Ulrich Stoeckle
Author: William R. Taylor
Author: Georg N. Duda

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