Abstract
Dislocation is a serious potential complication of total hip replacement. Previous studies have proposed a newly developed total hip structure that meets the required oscillation angle of 120°, for which the chamfer on the acetabular liner rim was designed to enable the neck to impinge on the chamfer over a large area after impingement occurs. This study adopted the finite element method to further analyse the torque limits leading to dislocation and the contact stresses at the impingement and egress sites of the liner during subluxation. The compressive stress–strain curve for ultra-high molecular weight polyethylene is nonlinear. The results reveal that an adequate chamfer angle of the acetabular cup liner can significantly increase dislocation torque and decrease contact stress on the liner rim. By means of the new design, when the head–neck ratio (HNR) is 2.5 or 3.0, the maximum torque value that a 36-mm head can withstand is 1.38 (8.7 Nm/6.3 Nm) or 1.47 (8.4 Nm/5.7 Nm) times that of a 22-mm head, while the maximum stress of a 36-mm head is 0.41 (14.58 MPa/35.73 MPa) or 0.70 (33.71 MPa/47.90 MPa) times that of a 22-mm head. When the head diameters are identical, the dislocation torque of the HNR = 2.5 structure is slightly greater than that of the HNR = 3.0 structure (3.3–10.5%); thus, the newly developed structure can disperse contact stress, and the structure of a large head with a low HNR exhibits a higher dislocation torque value and lower stress.
Similar content being viewed by others
References
Abraham R, Malkani AL (2005) Instability after total hip replacement. Semin Arthroplasty 16:132–141. doi:10.1053/j.sart.2005.06.002
Ali Khan MA, Brakenbury PH, Reynolds IS (1981) Dislocation following total hip replacement. J Bone Joint Surg Br 63:214–218
Barrack RL (2003) Dislocation after total hip arthroplasty: implant design and orientation. J Am Acad Orthop Surg 11:89–99
Barrack RL, Thornberry RL, Ries MD, Lavernia C, Tozakoglou E (2001) The effect of component design on range of motion to impingement in total hip arthroplasty. Instr Course Lect 50:275–280
Bartz RL, Noble PC, Kadakia NR, Tullos HS (2000) The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone Joint Surg Am 82:1300–1307
Bennett D, Humphreys L, O’Brien S, Kelly C, Orr JF, Beverland DE (2008) Wear paths produced by individual hip-replacement patients—a large-scale, long-term follow-up study. J Biomech 41:2474–2482
Besong A, Jin ZM, Fisher J (2000) Analysis of micro-separation and contact mechanics between the femoral head and the acetabular cup in artificial hip joint replacements. In: 47th annual meeting of the orthopaedic research society, pp 1051
Bistolfi A, Crova M, Rosso F, Titolo P, Ventura S, Massazza G (2011) Dislocation rate after hip arthroplasty within the first postoperative year: 36 mm versus 28 mm femoral heads. Hip Int 21:559–564. doi:10.5301/HIP.2011.8647
Brand RA, Crowninshield RD, Wittstock CE, Pedersen DR, Clark CR, van Krieken FM (1982) A model of lower extremity muscular anatomy. J Biomech Eng 104:304–310
Brand RA, Pedersen DR, Davy DT, Kotzar GM, Hieple KG, Goldberg VM (1994) Comparison of hip force calculations and measurements in the same patient. J Arthroplast 9:45–51
Brien WW, Salvati EA, Wright TM, Burstein AH (1993) Dislocation following THA: comparison of two acetabular component designs. Orthopedics 16:869–872. doi:10.3928/0147-7447-19930801-04
Brown TD, Callaghan JJ (2008) (ii) Impingement in total hip replacement: mechanisms and consequences. Curr Orthop 22:376–391. doi:10.1016/j.cuor.2008.10.009
Burroughs BR, Hallstrom B, Golladay GJ, Hoeffel D, Harris WH (2005) Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes: an in vitro study. J Arthroplast 20:11–19. doi:10.1016/j.arth.2004.07.008
Byström S, Espehaug B, Furnes O, Havelin LI (2003) Femoral head size is a risk factor for total hip luxation: a study of 42,987 primary hip arthroplasties from the Norwegian Arthroplasty Register. Acta Orthop Scand 74:514–524. doi:10.1080/00016470310017893
Clarke IC, Manley MT (2008) How do alternative bearing surfaces influence wear behavior. J Am Acad Orthop Surg 16:S86–S93
Cobb TK, Morrey BF, Ilstrup DM (1996) The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation. J Bone Joint Surg Am 78:80–86
Cobb TK, Morrey BF, Ilstrup DM (1997) Effect of the elevated-rim acetabular liner on loosening after total hip arthroplasty. J Bone Joint Surg Am 79:1361–1364
Conroy JL, Whitehouse SL, Graves SE, Pratt NL, Ryan P, Crawford RW (2008) Risk factors for revision for early dislocation in total hip arthroplasty. J Arthroplast 23:867–872. doi:10.1016/j.arth.2007.07.009
Cuckler JM, Moore KD, Lombardi AVJ, McPherson E, Emerson R (2004) Large versus small femoral heads in metal-on-metal total hip arthroplasty. J Arthroplast 19:41–44. doi:10.1016/j.arth.2004.09.006
D’Lima DD, Chen PC, Colwell CWJ (2001) Optimizing acetabular component position to minimize impingement and reduce contact stress. J Bone Joint Surg Am 83:87–91
Dudda M, Gueleryuez A, Gautier E, Busato A, Roeder C (2010) Risk factors for early dislocation after total hip arthroplasty: a matched case-control study. J Orthop Surg (Hong Kong) 18:179–183
Enocson A, Pettersson H, Ponzer S, Törnkvist H, Dalén N, Tidermark J (2009) Quality of life after dislocation of hip arthroplasty: a prospective cohort study on 319 patients with femoral neck fractures with a one-year follow-up. Qual Life Res 18:1177–1184. doi:10.1007/s11136-009-9531-x
Fialho JC, Fernandes PR, Eca L, Folgado J (2007) Computational hip joint simulator for wear and heat generation. J Biomech 40:2358–2366
Gilbert BJ, Hartman CW, Paprosky WG (2009) Contrained liners in revision total hip arthroplasty: an overuse syndrome - affirms. Semin Arthroplasty 20:85–88. doi:10.1053/j.sart.2008.11.015
Gonzalez Della Valle A, Ruzo PS, Li S, Pellicci P, Sculco TP, Salvati EA (2001) Dislodgment of polyethylene liners in first and second-generation Harris–Galante acetabular components. J Bone Joint Surg Am 83:553–559
Grigoris P, Grecula MJ, Amstutz HC (1994) Dislocation of a total hip arthroplasty caused by iliopsoas tendon displacement. Clin Orthop Rel Res 306:132–135
Hailer NP, Weiss RJ, Stark A, Kärrholm J (2012) The risk of revision due to dislocation after total hip arthroplasty depends on surgical approach, femoral head size, sex, and primary diagnosis- An analysis of 78,098 operations in the Swedish Hip Arthroplasty Register. Acta Orthop 83:442–448. doi:10.3109/17453674.2012.733919
Harris WH (1995) The problem is osteolysis. Clin Orthop Rel Res 311:46–53
Higa M, Tanino H, Abo M, Kakunai S, Banks SA (2011) Effect of acetabular component anteversion on dislocation mechanisms in total hip arthroplasty. J Biomech 44:1810–1813. doi:10.1016/j.jbiomech.2011.04.002
Jameson SS, Lees D, James P, Serrano-Pedraza I, Partington PF, Muller SD, Meek RMD, Reed MR (2011) Lower rates of dislocation with increased femoral head size after primary total hip replacement: a five-year analysis of NHS patients in England. J Bone Joint Surg Br 93:876–880. doi:10.1302/0301-620X.93B7.26657
Kang L, Galvin AL, Fisher J, Jin Z (2009) Enhanced computational prediction of polyethylene wear in hip joints by incorporating cross-shear and contact pressure in additional to load and sliding distance: effect of head diameter. J Biomech 42:912–918
Kim YH, Choi Y, Kim JS (2009) Influence of patient-, design-, and surgery-related factors on rate of dislocation after primary cementless total hip arthroplasty. J Arthroplast 24:1258–1263. doi:10.1016/j.arth.2009.03.017
Kluess D, Martin H, Mittelmeier W, Schmitz KP, Bader R (2007) Influence of femoral head size on impingement, dislocation and stress distribution in total hip replacement. Med Eng Phys 29:465–471. doi:10.1016/j.medengphy.2006.07.001
Ko BH, Yoon YS (2008) Optimal orientation of implanted components in total hip arthroplasty with polyethylene on metal articulation. Clin Biomech 23:996–1003. doi:10.1016/j.clinbiomech.2008.04.012
Kotwal RS, Ganapathim M, John A, Maheson M, Jones SA (2009) Outcome of treatment for dislocation after primary total hip replacement. J Bone Joint Surg Br 91:321–326. doi:10.1302/0301-620X.91B3.21274
Lin HC, Chi WM, Ho YJ, Chen JH (2013) Effects of design parameters of total hip components on the impingement angle and determination of the preferred liner skirt shape with an adequate oscillation angle. Med Biol Eng Comput 51:397–404. doi:10.1007/s11517-012-1008-3
Lin HC, Chi WM, Ho YJ, Lin CC, Chen JH (2015) Theoretical analysis of total hip dislocation and comparison of hemispherical cup and newly developed cup. J Med Biol Eng 35:661–669. doi:10.1007/s40846-015-0073-0
Lin HC, Luo TL, Chen JH (2012) Wear analysis of chamfered elongated acetabular cup liners. Med Biol Eng Comput 50:253–260. doi:10.1007/s11517-011-0852-x
Matsoukas G, Kim IY (2009) Design optimization of a total hip prosthesis for wear reduction. J Biomech Eng 131:051003(051001–051012). doi:10.1115/1.3049862
Matsushita A, Nakashima Y, Jingushi S, Yamamoto T, Kuraoka A, Iwamoto Y (2009) Effects of the femoral offset and the head size on the safe range of motion in total hip arthroplasty. J Arthroplast 24:646–651. doi:10.1016/j.arth.2008.02.008
McCollum DE, Gray WJ (1990) Dislocation after total hip arthroplasty- causes and prevention. Clin Orthop Rel Res 261:159–170
Nadzadi ME, Pedersen DR, Callaghan JJ, Brown TD (2002) Effects of acetabular component orientation on dislocation propensity for small-head-size total hip arthroplasty. Clin Biomech 17:32–40. doi:10.1016/S0268-0033(01)00096-1
Nadzadia ME, Pedersena DR, Yack HJ, Callaghan JJ, Brown TD (2003) Kinematics, kinetics, and finite element analysis of commonplace maneuvers at risk for total hip dislocation. J Biomech 36:577–591. doi:10.1016/S0021-9290(02)00232-4
Padgett DE, Lipman J, Robie B, Nestor B (2006) Influence of total hip design on dislocation. Clin Orthop Rel Res 447:48–52. doi:10.1097/01.blo.0000218748.30236.40
Peter R, Lubbeke A, Stern R, Hoffmeyer P (2011) Cup size and risk of dislocation after primary total hip arthroplasty. J Arthroplast 26:1305–1309. doi:10.1016/j.arth.2010.11.015
Prendergast PJ (1997) Finite element models in tissue mechanics and orthopaedic implant design. Clin Biomech 12:343–366. doi:10.1016/S0268-0033(97)00018-1
Raut VV, Siney PD, Wroblewski BM (1995) Cemented revision for aseptic acetabular loosening: a review of 387 hips. J Bone Joint Surg Br 77:357–361
Sanchez-Sotelo J, Berry DJ (2001) Epidemiology of instability after total hip replacement. Orthop Clin North Am 32:543–552
Scifert CF, Brown TD, Lipman JD (1999) Finite element analysis of a novel design approach to resisting total hip dislocation. Clin Biomech 14:697–703. doi:10.1016/S0268-0033(99)00054-6
Scifert CF, Brown TD, Pedersen DR, Callaghan JJ (1998) A finite element analysis of factors influencing total hip dislocation. Clin Orthop Rel Res 355:152–162
Shon WY, Baldini T, Peterson MG, Wright TM, Salvati EA (2005) Impingement in total hip arthroplasty: a study of retrieved acetabular components. J Arthroplast 20:427–435. doi:10.1016/j.arth.2004.09.058
Sikes CV, Lai LP, Schreiber M, Mont MA, Jinnah RH, Seyler TM (2008) Instability after total hip arthroplasty: treatment with large femoral heads vs constrained liners. J Arthroplast 23:59–63. doi:10.1016/j.arth.2008.06.032
Soong M, Rubash HE, Macaulay W (2004) Dislocation after total hip arthroplasty. J Am Acad Orthop Surg 12:314–321
Stewart T, Tipper J, Streicher R, Ingham E, Fisher J (2001) Long-term wear of HIPed alumina on alumina bearings for THR under microseparation conditions. J Mater Sci Mater Med 12:1053–1056
Tanino H, Harman MK, Banks SA, Hodge WA (2007) Association between dislocation, impingement, and articular geometry in retrieved acetabular polyethylene cups. J Orthop Res 25:1401–1407. doi:10.1002/jor.20410
Tanino H, Ito H, Banks SA, Harman MK, Matsuno T (2010) Use of a deep polyethylene liner for the treatment of recurrent dislocation. Hip Int 20:269–272
Tanino H, Ito H, Harman MK, Matsuno T, Hodge WA, Banks SA (2008) An in vivo model for intraoperative assessment of impingement and dislocation in total hip arthroplasty. J Arthroplast 23:714–720. doi:10.1016/j.arth.2007.07.004
Usrey MM, Noble PC, Rudner LJ, Conditt MA, Birman MV, Santore RF, Mathis KB (2006) Does neck/liner impingement increase wear of ultrahigh-molecular-weight polyethylene liners? J Arthroplast 21:S65–S71. doi:10.1016/j.arth.2006.05.013
Veitch SW, Jones SA (2009) (V) Prevention of dislocation in hip arthroplasty. Orthop Trauma 23:35–39. doi:10.1016/j.mporth.2009.01.005
Vendittoli PA, Ganapathi M, Nuño N, Plamondon D, Lavigne M (2007) Factors affecting hip range of motion in surface replacement arthroplasty. Clin Biomech 22:1004–1012. doi:10.1016/j.clinbiomech.2007.07.007
Williams S, Butterfield M, Stewart T, Ingham E, Stone M, Fisher J (2003) Wear and deformation of ceramic-on-polyethylene total hip replacements with joint laxity and swing phase microseparation. Proc Inst Mech Eng Part H-J Eng Med 217:147–153
Woo RY, Morrey BF (1982) Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64:1295–1306
Wu JSS, Hsu SL, Chen JH (2010) Evaluating the accuracy of wear formulae for acetabular cup liners. Med Biol Eng Comput 48:157–165. doi:10.1007/s11517-009-0535-z
Wu JSS, Hsu SL, Chen JH (2010) Wear patterns of, and wear volume formulae for, cylindrically elongated acetabular cup liners. Med Biol Eng Comput 48:691–701. doi:10.1007/s11517-010-0613-2
Wu JSS, Hsu SL, Chen JH (2010) Wear patterns of, and wear volume formulae for, hemispherical acetabular cup liners. Wear 268:481–487. doi:10.1016/j.wear.2009.09.007
Wu JSS, Hung JP, Shu CS, Chen JH (2003) The computer simulation of wear behavior appearing in total hip prosthesis. Comput Methods Programs Biomed 70:81–91
Yoshimine F (2005) The influence of the oscillation angle and the neck anteversion of the prosthesis on the cup safe-zone that fulfills the criteria for range of motion in total hip replacements. The required oscillation angle for an acceptable cup safe-zone. J Biomech 38:125–132. doi:10.1016/j.jbiomech.2004.03.012
Yoshimine F (2006) The safe-zones for combined cup and neck anteversions that fulfill the essential range of motion and their optimum combination in total hip replacements. J Biomech 39:1315–1323. doi:10.1016/j.jbiomech.2005.03.008
Yoshimine F, Ginbayashi K (2002) A mathematical formula to calculate the theoretical range of motion for total hip replacement. J Biomech 35:989–993. doi:10.1016/S0021-9290(02)00040-4
Acknowledgements
The authors would like to thank the National Science Council of the Republic of China, Taiwan, for financially supporting this research under Contract No. MOST 103-2221-E-040-004.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflicts of interest.
Additional information
Chien-Chung Lin and Wei-Min Chi made equal contributions to this work (co-first author).
Rights and permissions
About this article
Cite this article
Chi, WM., Lin, CC., Ho, YJ. et al. Using nonlinear finite element models to analyse stress distribution during subluxation and torque required for dislocation of newly developed total hip structure after prosthetic impingement. Med Biol Eng Comput 56, 37–47 (2018). https://doi.org/10.1007/s11517-017-1673-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-017-1673-3