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. 2020 Aug 25:2020:4809013.
doi: 10.1155/2020/4809013. eCollection 2020.

Acetabular Bone Defect in Total Hip Arthroplasty for Crowe II or III Developmental Dysplasia of the Hip: A Finite Element Study

Yinqiao Du  1 , Jun Fu  1 , Jingyang Sun  1 , Guoqiang Zhang  1 , Jiying Chen  1 , Ming Ni  1 , Yonggang Zhou  1
Affiliations

Acetabular Bone Defect in Total Hip Arthroplasty for Crowe II or III Developmental Dysplasia of the Hip: A Finite Element Study

Yinqiao Du et al. Biomed Res Int. .

Abstract

Background: The purpose of this study was to establish the finite element analysis (FEA) model of acetabular bone defect in Crowe type II or III developmental dysplasia of the hip (DDH), which could evaluate the stability of the acetabular cup with different types of bone defects, different diameters of femoral ceramic heads, and the use of screws and analyze the stress distribution of screws.

Methods: The FEA model was based on the CT scan of a female patient without any acetabular bone defect. The model of acetabular bone defect in total hip arthroplasty for Crowe II or III DDH was made by the increasing superolateral bone defect area of the acetabular cup. Point A was located in the most medial part of the acetabular bone defect. A 52 mm PINNACLE cup with POROCOAT Porous coating was implanted, and two screws (the lengths were 25 mm and 40 mm) were implanted to fix the acetabular cup. The stability of the acetabular cup and the von Mises stress of point A and screws were analyzed by a single-legged stance loading applied in 1948 N (normal working). The different diameters of the femoral ceramic head (28 mm, 32 mm, and 36 mm) were also analyzed.

Results: The von Mises stress of point A was gradually increased with the increasing uncoverage values. When the uncoverage values exceeded 24.5%, the von Mises stress of point A without screws increased significantly, leading to instability of the cup. Screws could effectively reduce the von Mises stress of point A with uncoverage values of more than 24.5%. However, the peak von Mises stress in the screws with the uncoverage values that exceeded 24.5% was considerably increased. The diameter of the femoral ceramic head had no significant effect on the von Mises stress and the stability of the acetabular cup.

Conclusions: We recommend that uncoverage values of less than 24.5% with or without screw is safe for patients with Crowe II or III DDH.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(a) The model of acetabular bone defect in total hip arthroplasty for Crowe II or III DDH. (b) The uncoverage area gradually increased by the length of the arc AC, and the angle α denoted the central angle of the uncovered portion above the cup. Angle α was formed by the crossing of line OA and OC. (c) Fixed constraint boundary conditions were assumed at the sacroiliac joint and pubic symphysis. (d) Simulated vertical reaction load was applied from the bottom of the femur.
Figure 2
Figure 2
The von Mises stress of point A without screw. (a) The length of arc AC was 0 mm with a 36 mm femoral ceramic head. (b) 4 mm. (c) 8 mm. (d) 12 mm. (e) 16 mm. (f) 20 mm. (g) 24 mm. (h) Relationship between the von Mises stress of point A (MPa) and the length of arc AC with different diameters of the femoral ceramic head.
Figure 3
Figure 3
Relationship between the von Mises stress of point A (MPa) and the length of arc AC with and without screw.
Figure 4
Figure 4
The stress distribution of the screw for fixing an acetabular cup: (a) 0 mm; (b) 4 mm; (c) 8 mm; (d) 12 mm; (e) 16 mm; (f) 20 mm; (g) 24 mm.
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