Biomechanical optimization of subject-specific implant positioning for femoral head resurfacing to reduce fracture risk.
Peri-prosthetic femoral neck fracture after femoral head resurfacing can be either patient-related or surgical technique-related. The study aimed to develop a patient-specific finite element modelling technique that can reliably predict an optimal implant position and give minimal strain in the peri-prosthetic bone tissue, thereby reducing the risk of peri-prosthetic femoral neck fracture. The subject-specific finite element modelling was integrated with optimization techniques including design of experiments to best possibly position the implant for achieving minimal strain for femoral head resurfacing. Sample space was defined by varying the floating point to find the extremes at which the cylindrical reaming operation actually cuts into the femoral neck causing a notch during hip resurfacing surgery. The study showed that the location of the maximum strain, for all non-notching positions, was on the superior femoral neck, in the peri-prosthetic bone tissue. It demonstrated that varus positioning resulted in a higher strain, while valgus positioning reduced the strain, and further that neutral version had a lower strain.
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia.
Brad
B
Miles
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia Elizabeth.Kolos@hotmail.com.
Elizabeth
E
Kolos
The Australian School of Advanced Medicine, Macquarie University, North Ryde, NSW, Australia.
Richard
R
Appleyard
School of Computer Science, Engineering and Mathematics, Flinders University, Adelaide, SA, Australia.
Willy
W
Theodore
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia.
Keke
K
Zheng
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia.
Qing
Q
Li
Biomedical Engineering, School of Aerospace, Mechanical and Mechatronic Engineering (AMME), University of Sydney, Sydney, NSW, Australia.
Andrew J
AJ
Ruys
D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001696:Biomechanical Phenomena; D005265:Femoral Neck Fractures / Q000517:prevention & control; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D020342:Finite Element Analysis; D006622:Hip Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008953:Models, Anatomic; D014057:Tomography, X-Ray Computed
Femoral head resurfacing; design of experiments; finite element analysis; goal-driven optimization