ABSTRACT
BACKGROUND: The femoral anterolateral column plays a key role in hip preservation surgery, and the China-Japan Friendship Hospital (CJFH) type stresses the anterolateral column, but there is little information available in three-dimensional (3D) finite element analysis of the L-type tantalum rod implantation.OBJECTIVE: To establish a 3D finite element model of L-type tantalum rod implantation into the normal, necrotic and L-type necrotic areas, followed by a finite element analysis, and to explore the importance of the integrity of the anterolateral column for hip preservation surgery, thus providing biomechanical evidence for the treatment of CJFH type.METHODS: Based on the prepared 3D models of CJFH L1, L2 and L3 osteonecrosis of the femoral head (ONFH) and normal hip, the 3D finite element model of tantalum rod implantation of femoral head necrosis was established, and finite element analysis was conducted. The stress distribution and the maximum Mises stress value of cortical shell of normal femoral head, necrotic femoral head and tantalum rod implanted ONFH were observed and compared.RESULTS AND CONCLUSION: (1) The maximum Mises of the weight-bearing area of cortical bone shell of L-type ONGH was higher than that of normal femoral, L1. L2 and L3 increased by 21.76%, 31.02%, and 42.79%, respectively. (2) The maximum Mises of weight-bearing area of cortical bone shell was decreased after tantalum rod implantation, L1 L2 and L3 decreased by 13.38%, 8.81%, and 11.45%, respectively. (3) In necrotic femoral head, the decreased bearing stress, leads to stress concentration on the femoral head bone shell, so the maximum is higher than that of the normal condition. The higher classification is, the greater the stress concentration of the cortical bone shell is. Tantalum rod implantation share certain stress. (4) Tantalum rod implantation corrects some stresses of the bone shell of ONFH, and can prevent collapse and exert the biomechanical effect of supporting subchondral bone. Furthermore, the integrity of the lateral column of the necrotic femoral head affects the efficacy of hip preservation, and more lateral column preserved always accompanied with better hip preservation. The higher CJFH classification exhibits a higher risk of collapse, and poorer hip preservation.