Stress distribution after total hip arthroplasty with a neck-retaining femoral prosthesis / 中国组织工程研究

ABSTRACT

BACKGROUND:Col um Femoris Preserving prosthesis is developed by Pipino, an Italian surgeon, and LINK (Germany). Whether the femoral osteotomy plane recommended in the surgical manual is suitable for Chinese people and whether the osteotomy method can cause stress changes of the prosthesis and femur has not been yet reported. OBJECTIVE:Based on clinical reviews and three-dimensional finite element model, to analyze the clinical efficacy of total hip arthroplasty with Col um Femoris Preserving prosthesis and relevant stress distribution. METHODS:We retrospectively analyzed 36 patients undergoing total hip arthroplasty with neck-retaining femoral prosthesis and 36 patients receiving total hip arthroplasty with biotype prosthesis in terms of Harris scores, visual analog scale scores, preoperative and postoperative measurements of eccentricity changes, IDES-Engh radiological evaluation and the incidence of complications. Two different osteotomy plane finite element analysis models were created to analyze the eccentricity difference and changes in the stress distribution of prosthesis and femur when the osteotomy plane was set 1.5 cm above the intertrochanteric fossa or at the junction of femoral head and neck. RESULTS AND CONCLUSION:Neck-retaining total hip arthroplasty with the osteotomy plane set at the junction between the head and neck achieved good short-term outcomes, showing no difference from total hip arthroplasty with normal biological prosthesis. The finite element analysis showed that the eccentricity increased and the stress on the prosthesis and femur also increased when the osteotomy plane was set at the junction of femoral head and neck compared with that set 1.5 cm above the intertrochanteric fossa. But there was no difference in stress distribution between two osteotomy planes.