Closure of the hip joint capsule defect with a propylene mesh. Clinical and biomechanical research
Dislocation of the femoral component of the endoprosthesis is one of the most common complications after hip total arthroplasty. The best way of prevention is to prevent the development of primary instability. Even with the proper positioning of endoprosthesis components, there are dislocations associated with the weakness or defect of the capsular-connective structures of the joint. Today, a lot of ways have been developed to strengthen and restore the posterior structures of the capsule of the hip joint with the help of auto and allomaterials, differing in the method of fixation and physical and chemical characteristics.
The paper proposes a method of restoring and strengthening the posterior structures of the capsule using polypropylene mesh implants. Objective: to construct a model of the hip
joint capsule after capsulotomy with the help of the specialized software program and to determine the hardness of the defect closed with a polypropylene mesh. Methods: the study was made in a software complex based on the finite element method. A calculation model was constructed consisting of capsule and endoprosthesis femoral head. Two methods of sewing the dissected capsule were studied: seam thread and polypropylene mesh. In the control model, the capsule was not fixed. Results: pictures of the distribution of stress-strain state in the system «endoprosthesis – joint capsule» were obtained. Conclusions: under
the conditions of the kinematic loading of the model, the smallest sizes of the capsule cut opening are in case of its closure with the mesh. In the case of thread, they were 8.5 % higher. The values of equivalent stresses in the model with the mesh were the largest: in the capsule of the joint by 23.8 %, the endoprosthesis head — by 60.4 % compared with the thread fixation. The obtained results indicate that the mesh model is more rigid.
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