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Technical Brief

Altered Load Transfer in the Pelvis in the Presence of Periprosthetic Osteolysis

[+] Author and Article Information
Jacob T. Munro

Auckland Bioengineering Institute,
University of Auckland,
Auckland 1142, New Zealand
e-mail: jacob.munro@auckland.ac.nz

Justin W. Fernandez

Auckland Bioengineering Institute,
University of Auckland,
Auckland 1142, New Zealand
e-mail: j.fernandez@auckland.ac.n

James S. Millar

Auckland Bioengineering Institute,
University of Auckland,
Auckland 1142, New Zealand
e-mail: james.s.millar@gmail.com

Cameron G. Walker

Auckland Bioengineering Institute,
University of Auckland,
Auckland 1142, New Zealand
e-mail: c.walker@auckland.ac.nz

Donald W. Howie

Royal Adelaide Hospital,
University of Adelaide,
Adelaide 1142, South Australia
e-mail: Donald.Howie@health.sa.gov.au

Vickie B. Shim

Auckland Bioengineering Institute,
University of Auckland,
Auckland 1142, New Zealand
e-mail: v.shim@auckland.ac.nz

1Corresponding author.

Manuscript received February 27, 2014; final manuscript received August 23, 2014; accepted manuscript posted September 11, 2014; published online September 24, 2014. Assoc. Editor: David Corr.

J Biomech Eng 136(11), 114502 (Sep 24, 2014) (7 pages) Paper No: BIO-14-1096; doi: 10.1115/1.4028522 History: Received February 27, 2014; Revised August 23, 2014; Accepted September 11, 2014

Periprosthetic osteolysis in the retroacetabular region with cancellous bone loss is a recognized phenomenon in the long-term follow-up of total hip replacement. The effects on load transfer in the presence of defects are less well known. A validated, patient-specific, 3D finite element (FE) model of the pelvis was used to assess changes in load transfer associated with periprosthetic osteolysis adjacent to a cementless total hip arthroplasty (THA) component. The presence of a cancellous defect significantly increased (p < 0.05) von Mises stress in the cortical bone of the pelvis during walking and a fall onto the side. At loads consistent with single leg stance, this was still less than the predicted yield stress for cortical bone. During higher loads associated with a fall onto the side, highest stress concentrations occurred in the superior and inferior pubic rami and in the anterior column of the acetabulum with larger cancellous defects.

FIGURES IN THIS ARTICLE
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Copyright © 2014 by ASME
Topics: Stress , Bone
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References

Figures

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Fig. 1

Axial CT slices demonstrating osteolysis in the retroacetabular region in 2001 (a) and 2004 (b). Defect progression by 2004 has resulted in destruction of the cortical bone on the right side (white arrow) and the increasing cyst volume on the left (black arrow). Note the sclerotic areas of higher density bone within the cancellous region extending from the cup (dashed arrow).

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Fig. 2

Lateral and medial views of the right pelvis mesh with numbered ROI used for statistical analysis

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Fig. 3

Pelvis meshes with 2004 defects on the right (a) and left (b) in association with the implant

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Fig. 4

The von Mises stresses during single leg stance for left and right hemipelvis comparing models without a defect to models with defects present in 2004. Highest increases in stress (solid circles) occurred in the posterior column in close proximity to the defect and anterior column on the left side. The cortical defect in the medial wall of the right hemipelvis (hashed circle) did not lead to increases in mean stress at the applied load.

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Fig. 5

The von Mises stresses following a fall directly onto the side comparing models without a defect to models with defects present in 2004. Similar increases in stress are seen (solid circles) in the posterior column of both sides and the anterior wall and column on the left. The pubic symphysis (arrow) showed very high stress in all models.

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Fig. 6

An AP view combining the 2004 left and right hemipelves after application of loads consistent with a fall onto the respective sides. Note the distribution of high von Mises stress in the anterior wall and column of the left hemipelvis (black arrow) with the larger defect. Both pubic rami also demonstrate high stress concentrations.

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