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Biomechanical rationale for acetubalar component selection for total hip replacement in patients with dysplastic coxarthrosis

Oleg Loskutov

Abstract


Loss of anatomical shape of acetabulum under the dysplastic hip arthrosis, presence of defects and segmental bone deficiency in this area cause problems when choosing acetabular cup de­sign.

Objective: a comparative biomechanical evaluation of sta­bility of pressing cup fixation and screw in terms of acetabulum segmental defect in patients with dysplastic coxarthrosis for ar­throplasty.

Methods: we developed a simplified geometric hexa­decimal hip model with defects of segmental ter circuit 30°, 60°, 90° and 120°; and finite-element model of «bone – cup – insert – head implant» and estimated stress-strain distribution under axial load of 1000 N.

Results: in the case of pressing cups and screw fixation, provided segmental defect up to 30°, the maxi­mum stress in the bone bed is close to that of a healthy joint. This provides a higher quality cup screws initial stability. Given seg­mental defects of acetabulum 60°, 120° and 90° to reduce stress-strain distribution in bones must perform free plastic and bone screws to apply the cup. Use of pressing cups, with segmental defects over 60° is problematic.

Conclusions: both types of fix­ing cup endoprosthesis provide stress-strain distribution simi­lar to that of a healthy joint. The presence of segmental defect up to 30° did not significantly affect the stiffness and strength of the pelvic bone when using screws cup. Given the short-cir­cuit defect 30° to 60° there is the threat of cracking. If the size of the defect exceeds 60°, significantly increases the risk of de­struction circuit. Cup, pressed as compared to screws, moving under a static load of 1000 H.

Keywords


dysplastic coxarthrosis; hip replacement; segmental acetabular defects stress-strain distribution; finite element method

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DOI: https://doi.org/10.15674/0030-59872017214-22

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