Journal article
Bone-on-bone versus hardware impingement in total hips: a biomechanical study
The Iowa orthopaedic journal, Vol.32, pp.17-21
2012
PMCID: PMC3565398
PMID: 23576916
Appears in Diamond Open Access
Abstract
Dislocation remains a serious concern for total hip arthroplasty (THA). Impingement, typically between the implant femoral neck and the acetabular cup, remains the most common dislocation impetus. Wear reductions from recent bearing technology advancements have encouraged introduction of substantially increased femoral head diameters. However, there is some evidence that range of motion with larger head sizes is limited by bone-on-bone, rather than hardware, impingement. While all impingement events are of course undesirable, currently little is known biomechanically if these two impingement modes differ in terms of generation of potentially deleterious stress concentrations or with regard to dislocation resistance. Finite element (FE) analysis was therefore used to parametrically investigate the role of head diameter on the local biomechanics of bone-on-bone versus component-on-component impingement events. Of several dislocation-prone patient motion challenges considered, only squatting consistently resulted in bone-on-bone (as opposed to hardware) impingement. Implant stress concentrations arising from hardware impingement during squatting were greater than those from bony impingement, for all head sizes considered. Additionally, dislocation resistance was substantially greater for instances of bony impingement versus hardware-only impingement. These findings suggest that hardware impingement may still be a/the the predominant mode of impingement even with the use of larger femoral heads, for sub-optimally positioned cups. Additionally, the data indicate that, should impingement occur, impingements between the implant neck and cup are (1) more likely to dislocate, and (2) have a greater propensity for causing damage to the implant compared to impingement events involving bony members.
Details
- Title: Subtitle
- Bone-on-bone versus hardware impingement in total hips: a biomechanical study
- Creators
- Jacob M Elkins - University of IowaDouglas R PedersenJohn J CallaghanThomas D Brown
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.32, pp.17-21
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 23576916
- PMCID
- PMC3565398
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Grant note
- AR46601 / NIAMS NIH HHS TL1 RR024981 / NCRR NIH HHS R01 AR053553 / NIAMS NIH HHS R24 AR046601 / NIAMS NIH HHS UL1 RR024979 / NCRR NIH HHS AR53553 / NIAMS NIH HHS R01 AR046601 / NIAMS NIH HHS
- Language
- English
- Date published
- 2012
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation
- Record Identifier
- 9984304697402771
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