Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR

Journal of Orthopaedic Surgery and Research

Carsten Perka¹  Georg N Duda¹  Andrew Speirs¹  Dong-Yeong Kim¹  William R Taylor¹  Manav Mehta¹  Markus O Heller¹ 

[1]Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Germany

关键词: computational modelling;    physiological loading;    surgical technique;    implant design;    implant stresses;    revision hip arthroplasty;   

Others  :  823719
DOI  :  10.1186/1749-799X-6-20

 received in 2010-07-16, accepted in 2011-05-13,  发布年份 2011

【 摘 要 】

Background

Femoral offset influences the forces at the hip and the implant stresses after revision THR. For extended bone defects, these forces may cause considerable bending moments within the implant, possibly leading to implant failure. This study investigates the influences of femoral anteversion and offset on stresses in the Wagner SL revision stem implant under varying extents of bone defect conditions.

Methods

Wagner SL revision stems with standard (34 mm) and increased offset (44 mm) were virtually implanted in a model femur with bone defects of variable extent (Paprosky I to IIIb). Variations in surgical technique were simulated by implanting the stems each at 4° or 14° of anteversion. Muscle and joint contact forces were applied to the reconstruction and implant stresses were determined using finite element analyses.

Results

Whilst increasing the implant's offset by 10 mm led to increased implant stresses (16.7% in peak tensile stresses), altering anteversion played a lesser role (5%). Generally, larger stresses were observed with reduced bone support: implant stresses increased by as much as 59% for a type IIIb defect. With increased offset, the maximum tensile stress was 225 MPa.

Conclusion

Although increased stresses were observed within the stem with larger offset and increased anteversion, these findings indicate that restoration of offset, key to restoring joint function, is unlikely to result in excessive implant stresses under routine activities if appropriate fixation can be achieved.

【 授权许可】

   
2011 Heller et al; licensee BioMed Central Ltd.

【 图 表 】

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