Abstract
Objective This study investigated the stress distribution in a femur after a cemented prosthetic replacement surgery in elderly patients with a partial marrow type I intertrochanteric fracture and compared the differences in stress distribution between a long- and short-stem prosthetic replacement. Methods A spiral computed tomography (CT) scan was used on the volunteer’s right femur to obtain image data, which were processed with the Mimics software and the modeling software to reconstruct a three-dimensional model of the femur. On this basis, the three-dimensional physical models for a partial marrow type intertrochanteric fracture, long- and short-stem femoral prostheses, and the mantle layer of cement were established. Finally, the three-dimensional finite element models of the long- and short-stem femoral prostheses as a treatment of an intertrochanteric fracture were established using the software for finite element analysis, and the biomechanical analysis was implemented for the models. Results The stress distribution in the femur after the cemented long- or short-stem prosthetic replacement did not change significantly; it still gradually increased from the proximal end to the distal end, reaching the peak value at the lower 1/3 of the medial and lateral junction, and then decreased to the end. Although a stress concentration zone formed in the medial and lateral end of the bone cement-prosthetic stem interface in the short-stem prosthesis, which had a lateral peak value of 15.3 MPa, it did not exceed the fatigue strength of the bone cement. Alternatively, a stress concentration zone formed in the distal medial and lateral end of the bone cement-prosthetic stem interface and the medial middle part of the shaft in the long-stem prosthesis, which showed a peak value that was also lower than the fatigue strength of the bone cement. No significant stress concentration zones were found in the femoral calcar reconstructed by bone cement. Conclusion The stress distribution in the femur did not change significantly after cemented long- and short-stem prosthetic replacements were used for elderly patients with a partial marrow type I intertrochanteric fracture. The probability of loosening of the cemented long-stem prosthesis was comparable to that of the short-stem prosthesis, but the latter may be more suitable for treating elderly patients with a partial marrow type I intertrochanteric fracture due to the shorter surgery time, minor trauma, and fewer complications.
Fund: medical research project of Chongqing Health Bureau, No. 2011-2-371.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Haidukewych GJ, Israel TA, Berry DJ (2001) Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg 83(5):643–650
Wang S, Tan Z, Zhou M et al (2012) New fracture classification and guidance treatment for femoral intertrochanteric comminuted fracture with locking plate. Chin J Bone Jt Inj 27(2):103–106
Ramaniraka NA, Rakotomanana LR, Leyvraz PF (2000) The fixation of the cemented femoral component: effects of stem stiffness, cement thickness and roughness of the cement. bone surface. J Bone Joint Surf 82(2):297–303
Kowalczyk P (2001) Design optimization of cementless femoral hip prostheses using finite element analysis. J Biomech Eng 23(5):396–402
Liu Y-P, Liu X, Yu H et al (eds) (2002) The diagnostic classification and functional assessment standards for bone and joint injuries and diseases, 1st edn. Tsinghua University Press, Beijing, pp 71–73
Zhang W, Zou J, Luo C et al (2004) The comparative study of the treatment to intertrochanteric fractures and subtrochanteric fractures of the elderly patients. Chin J. Orthop (11):649–652
Simmernacher RK (2008) The new proximal femoral nail antirotation (PFNA) in daily practice: Results of a multicentre clinical study. Injury 39(8):932–939
Wang S, Jiang D, Tan Z et al (2011) New classification of intertrochanteric fracture and its applications in artificial joint replacement. Chin J Bone Jt Inj 26(10):884–886
Wnag X, Feng G et al (2007) Classification of intertrochanteric fracture and selection of the internal fixation methods. Chin J Bone Jt Inj 22(10):814–816
Chen D, Li X (2009) Classification and treatment progress of intertrochanteric fracture [J]. Asia-Pacific Tradit Med 5(6):148–150
Wang S, Tan Z, Zhou M et al (2012) Treating femoral intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures using anatomic locking plate. Chin J Orthop 32(7):626–631
Wang X, Dong Q, Zheng Z et al (2007) Long-stem bipolar femoral head prosthetic replacement for elderly patients with femoral intertrochanteric fracture. Chin J Bone Jt Inj 22(9):714–716
Luo J, Zhu G, Chen D et al (2006) Hemiarthroplasty treatment for elderly patients with unstable intertrochanteric fracture. Chin Bone Jt Inj 21(1):60–61
Li Y, Zhang L, Yang G et al (2007) Progress in the finite element analysis for biomechanics of total hip arthroplasty. Chin J Orthop Trauma 9(3):277–289
Liu A, Zhang Y, Wang C et al (2001) Three-dimensional finite element analysis for the biomechanical properties of human femur. J Xi’an Med Univ (Chinese) 22(3):242–244
Ma JX, Ma XL, Zhang QG et al (2008) Three-dimensional finite element analysis of femur’s biomechanics in normal standing position. J Clin Rehabilitative Tissue Eng Res 12(35):6823–6826
Dong Y, Huang T, Li W et al (2002) Image anatomy of femoral marrow cavity in adults and its clinical significance. Chin J Clin Anat 20(1):18–20
Estok DM 2nd, Harris WH (2000) A stem design change to reduce peak cement strains at the tip of cemented total hip arthroplasty. J Arthroplasty l5(5):584–589
Jansson V, Refior HJ (1993) Mechanical failure of the femoral component in cemented total hip replacement-a finite element evaluation. Arch Orthop Trauma Surg 113(1):23–27
Breusch SJ, Lukoschek M. Kreutzer J et al (2001) Dependency of cement mantle thickness on femoral stem design and centralizer. J Arthroplasty l6(5):648–657
Kawate K, Ohmura T, Nakajima H et al (2001) Distal cement mantle thickness with a triangular distal centralizer inserted into the stem tip in cemented total hip arthroplasty. J Arthroplasty 16(8):998–1003
Ayers D, Mann K (2003) The importance of proximal cement filling of the calcar region: a biomechanical justification. J Arthroplasty 18(7 Suppl l):103–109
Powers CM, Lee IY, Skinner HB et al (1998) Effects of distal cement voids on cement stress in total hip arthroplasty. J Arthroplasty 13(7):793–798
Lewis G, Austin GE (1994) Mechanical properties of vacuum-mixed acrylic bone cement. J Appl Biomater 5(4):307–314
Lewis G (2003) Fatigue testing and performance of acrylic bone-cement materials: state-of-the-art review. J Biomed Mater Res B Appl Biomater 66(1):457–486
Krause W, Mathis RS (1988) Fatigue properties of acrylic bone cements: review of the literature. J Biomed Mater Res 22(A 1 Suppl):37–53
Wang S, Liu S, Liu W et al (2010) The finite element analysis of cemented long- and short-stem prosthetic replacement in aged patients with comminuted intertrochanteric fracture. Chin J of Ortho 30(11):1144–1150
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media Dordrecht
About this paper
Cite this paper
Shao-lin, W., Zu-jian, T., Ming-quan, Z. (2014). The Comparative Analysis with Finite Element for Cemented Long- and Short-Stem Prosthetic Replacement in Elderly Patients with a Partial Marrow Type I Intertrochanteric Fracture. In: Li, S., Jin, Q., Jiang, X., Park, J. (eds) Frontier and Future Development of Information Technology in Medicine and Education. Lecture Notes in Electrical Engineering, vol 269. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7618-0_17
Download citation
DOI: https://doi.org/10.1007/978-94-007-7618-0_17
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-7617-3
Online ISBN: 978-94-007-7618-0
eBook Packages: EngineeringEngineering (R0)