Abstract:BackgroundThere is no universal hip implant suitably fills all femoral types, whether prostheses of porous short-stem suitable for Hip Arthroplasty is to be measured scientifically.MethodsTen specimens of femurs scanned by CT were input onto Mimics to rebuild 3D models; their *stl format dataset were imported into Geomagic-Studio for simulative osteotomy; the generated *.igs dataset were interacted by UG to fit solid models; the prosthesis were obtained by the same way from patients, and bored by punching bear… Show more
“…4 a). The results were similar to that of comparable studies [ 24 , 25 ], which demonstrated the reliability of the finite element model. Fig.…”
Section: Resultssupporting
confidence: 89%
“…The Fig. 3 The prosthesis migration evaluation: the stem tip migration was calculated as [(a-A) + (B-b)]/2 results were similar to that of comparable studies [24,25], which demonstrated the reliability of the finite element model.…”
Section: The Stress and Displacement Of The Normal Femursupporting
confidence: 72%
“…Coherently, FEMs presented in the present study showed that the remaining femur reconstructed by the straight stem had the highest extent of stress concentration and displacement (Fig. 5 d), which indicated poor stability of the surgical reconstruction and an increased possibility of mechanical failure [ 24 , 25 ].…”
Background
Hip-preserved reconstruction for patients with ultrashort proximal femur segments following extensive femoral diaphyseal tumor resection is a formidable undertaking. A customized intercalary prosthesis with a rhino horn-designed uncemented stem was developed for the reconstruction of these extensive skeletal defects.
Methods
This study was designed to analyze and compare the differences in the biomechanical behavior between the normal femur and the femur with diaphyseal defects reconstructed by an intercalary prosthesis with different stems. The biomechanical behavior under physiological loading conditions is analyzed using the healthy femur as the reference. Five three-dimensional finite element models (healthy, customized intercalary prosthesis with four different stems implemented, respectively) were developed, together with a clinical follow-up of 12 patients who underwent intercalary femoral replacement.
Results
The biomechanical results showed that normal-like stress and displacement distribution patterns were observed in the remaining proximal femur segments after reconstructions with the rhino horn-designed uncemented stems, compared with the straight stem. Stem A showed better biomechanical performance, whereas the fixation system with Stem B was relatively unstable. The clinical results were consistent with the FEA results. After a mean follow-up period of 32.33 ± 9.12 months, osteointegration and satisfactory clinical outcomes were observed in all patients. Aseptic loosening (asymptomatic) occurred in one patient reconstructed by Stem B; there were no other postoperative complications in the remaining 11 patients.
Conclusion
The rhino horn-designed uncemented stem is outstanding in precise shape matching and osseointegration. This novel prosthesis design may be beneficial in decreasing the risk of mechanical failure and aseptic loosening, especially when Stem A is used. Therefore, the customized intercalary prosthesis with this rhino horn-designed uncemented stem might be a reasonable alternative for the reconstruction of SSPF following extensive tumor resection.
“…4 a). The results were similar to that of comparable studies [ 24 , 25 ], which demonstrated the reliability of the finite element model. Fig.…”
Section: Resultssupporting
confidence: 89%
“…The Fig. 3 The prosthesis migration evaluation: the stem tip migration was calculated as [(a-A) + (B-b)]/2 results were similar to that of comparable studies [24,25], which demonstrated the reliability of the finite element model.…”
Section: The Stress and Displacement Of The Normal Femursupporting
confidence: 72%
“…Coherently, FEMs presented in the present study showed that the remaining femur reconstructed by the straight stem had the highest extent of stress concentration and displacement (Fig. 5 d), which indicated poor stability of the surgical reconstruction and an increased possibility of mechanical failure [ 24 , 25 ].…”
Background
Hip-preserved reconstruction for patients with ultrashort proximal femur segments following extensive femoral diaphyseal tumor resection is a formidable undertaking. A customized intercalary prosthesis with a rhino horn-designed uncemented stem was developed for the reconstruction of these extensive skeletal defects.
Methods
This study was designed to analyze and compare the differences in the biomechanical behavior between the normal femur and the femur with diaphyseal defects reconstructed by an intercalary prosthesis with different stems. The biomechanical behavior under physiological loading conditions is analyzed using the healthy femur as the reference. Five three-dimensional finite element models (healthy, customized intercalary prosthesis with four different stems implemented, respectively) were developed, together with a clinical follow-up of 12 patients who underwent intercalary femoral replacement.
Results
The biomechanical results showed that normal-like stress and displacement distribution patterns were observed in the remaining proximal femur segments after reconstructions with the rhino horn-designed uncemented stems, compared with the straight stem. Stem A showed better biomechanical performance, whereas the fixation system with Stem B was relatively unstable. The clinical results were consistent with the FEA results. After a mean follow-up period of 32.33 ± 9.12 months, osteointegration and satisfactory clinical outcomes were observed in all patients. Aseptic loosening (asymptomatic) occurred in one patient reconstructed by Stem B; there were no other postoperative complications in the remaining 11 patients.
Conclusion
The rhino horn-designed uncemented stem is outstanding in precise shape matching and osseointegration. This novel prosthesis design may be beneficial in decreasing the risk of mechanical failure and aseptic loosening, especially when Stem A is used. Therefore, the customized intercalary prosthesis with this rhino horn-designed uncemented stem might be a reasonable alternative for the reconstruction of SSPF following extensive tumor resection.
“…With the progress of socialization in China, the aging of population has been increasingly prominent. The elderly population is often accompanied with various medical diseases, especially in middle-aged women who are often accompanied with osteoporosis, so the slight trauma can lead to femoral intertrochanteric fracture easily ( 1 ). Intertrochanteric fractures in senile patients are mostly unstable fractures accompanied with osteoporosis, while the fractures are often comminuted, involving the large and small intertrochanteric fractures.…”
Curative effect of artificial femoral head replacement on hip joint function and complications of elderly patients with femoral intertrochanteric fracture were investigated. Eighty patients who were operated for femoral intertrochanteric fractures operation were randomly divided into observation group (n=40) and control group (n=40). The observation group was treated with artificial femoral head replacement, while the control group received internal proximal femur locking plate fixation. In the observation group, the operation time was shorter than that in the control group (P<0.05). The intraoperative bleeding was less than that in the control group (P<0.05). The postoperative indwelling drainage time was shorter than that in the control group (P<0.05). Besides, at 3, 6 and 12 months after operation, 10 m walking speed in the observation group was significantly higher than that in the control group (P<0.05). The 5-time sit-stand time was shorter than that in the control group (P<0.05). At 1 week, 1 month, 3, 6 and 12 months after operation, Harris hip joint scores and visual analogue scale scores in the observation group were both superior to those in the control group (P<0.05). Moreover, the total hospitalization time in the observation group was shorter than that in the control group. Time of walking on crutches and walking without crutches was earlier than that in the control group (P<0.05). The overall proportion of postoperative chronic pain, thrombosis and failed surgery in the observation group was significantly lower than that in the control group (P<0.05). Finally, physical and psychological scores in the observation group after intervention were obviously higher than those in the observation group before intervention and the control group after intervention (P<0.05). Artificial femoral head replacement is characterized by the short operation time, less intraoperative bleeding, fast postoperative recovery of joint function, low degree of pain and fewer complications in the treatment of senile femoral intertrochanteric fracture, which can improve the postoperative life quality of patients.
“…Joint replacement is a prevalent approach to achieve function restoration of degenerative joint diseases [1]. Therefore, the analysis of the mechanical properties of the femur is of great significance in the design and manufacture of the implantable prosthesis [2].…”
Abstract. As the largest and longest bone in the human body, the femur has important research value and application prospects. This paper introduces a fast reconstruction method with Mimics and ANSYS software to realize the heterogeneous modelling of the femur according to Hu distribution of the CT series, and simulates it in various situations by finite element analysis to study the mechanical characteristics of the femur. The femoral heterogeneous model shows the distribution of bone mineral density and material properties, which can be used to assess the diagnosis and treatment of bone diseases. The stress concentration position of the femur under different conditions can be calculated by the simulation, which can provide reference for the design and material selection of prosthesis.
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