The capsule's contribution to total hip construct stability--a finite element analysis

Jacob M Elkins; Nicholas J Stroud; M James Rudert; Yuki Tochigi; Douglas R Pedersen; Benjamin J Ellis; John J Callaghan; Jeffrey A Weiss; Thomas D Brown

doi:10.1002/jor.21435

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The capsule's contribution to total hip construct stability--a finite element analysis

Journal article

Open access

Peer reviewed

The capsule's contribution to total hip construct stability--a finite element analysis

Jacob M Elkins, Nicholas J Stroud, M James Rudert, Yuki Tochigi, Douglas R Pedersen, Benjamin J Ellis, John J Callaghan, Jeffrey A Weiss and Thomas D Brown

Journal of orthopaedic research, Vol.29(11), pp.1642-1648

11/2011

DOI: 10.1002/jor.21435

PMCID: PMC3160501

PMID: 21495065

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Abstract

Instability is a significant concern in total hip arthroplasty (THA), particularly when there is structural compromise of the capsule due to pre-existing pathology or due to necessities of surgical approach. An experimentally grounded fiber-direction-based finite element model of the hip capsule was developed, and was integrated with an established three-dimensional model of impingement/dislocation. Model validity was established by close similarity to results from a cadaveric experiment in a servohydraulic hip simulator. Parametric computational runs explored effects of graded levels of capsule thickness, of regional detachment from the capsule's femoral or acetabular insertions, of surgical incisions of capsule substance, and of capsule defect repairs. Depending strongly upon the specific site, localized capsule defects caused varying degrees of construct stability compromise, with several specific situations involving over 60% decrement in dislocation resistance. Construct stability was returned substantially toward intact-capsule levels following well-conceived repairs, although the suture sites involved were often at substantial risk of failure. These parametric model results underscore the importance of retaining or robustly repairing capsular structures in THA, in order to maximize overall construct stability.

Arthroplasty, Replacement, Hip - adverse effects

Cadaver

Databases, Factual

Equipment Failure Analysis - methods

Finite Element Analysis

Hip Joint - diagnostic imaging

Hip Joint - physiology

Hip Joint - surgery

Humans

Joint Capsule - diagnostic imaging

Joint Capsule - physiology

Joint Capsule - surgery

Models, Anatomic

Postoperative Complications - diagnostic imaging

Postoperative Complications - physiopathology

Stress, Mechanical

Suture Techniques - adverse effects

Tomography, X-Ray Computed

Details

Title: Subtitle: The capsule's contribution to total hip construct stability--a finite element analysis
Creators: Jacob M Elkins - University of Iowa
Nicholas J Stroud - University of Iowa
M James Rudert - University of Iowa
Yuki Tochigi - University of Iowa
Douglas R Pedersen - University of Iowa
Benjamin J Ellis - University of Utah
John J Callaghan - University of Iowa
Jeffrey A Weiss - University of Utah
Thomas D Brown - University of Iowa
Resource Type: Journal article
Publication Details: Journal of orthopaedic research, Vol.29(11), pp.1642-1648
DOI: 10.1002/jor.21435
PMID: 21495065
PMCID: PMC3160501
NLM abbreviation: J Orthop Res
ISSN: 0736-0266
eISSN: 1554-527X
Grant note: AR46601 / NIAMS NIH HHS R01 AR053553 / NIAMS NIH HHS R24 AR046601 / NIAMS NIH HHS R01 AR053553-04 / NIAMS NIH HHS R01 AR046601-05 / NIAMS NIH HHS AR53553 / NIAMS NIH HHS R01 AR046601 / NIAMS NIH HHS
Language: English
Date published: 11/2011
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
Record Identifier: 9984304703202771

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