Metal-on-metal hip resurfacing is becoming increasingly popular, and a number of new devices have been recently introduced that, in the short term, appear to have satisfactory outcome but many questions are still open on the biomechanics of the resurfaced femur. This could be investigated by means of finite element analysis, but, in order to be effective in discerning potential critical conditions, the accuracy of the models’ predictions should be assessed. The major goal of this study was to validate, through a combined experimental-numerical study, a finite element modeling procedure for the simulation of resurfaced femurs. In addition, a preliminary biomechanical analysis of the changes induced in the femoral neck biomechanics by the presence of the device was performed, under a physiologic range of hip joint reaction directions. For this purpose, in vitro tests and a finite element model based on the same specimen were developed using a cadaver femur. The study focused on the Conserve Plus, one of the most common contemporary resurfacing designs. Five loading configurations were identified to correspond to the extremes of physiological directions for the hip joint. The agreement between experimental measurements and numerical predictions was good both in the prediction of the femoral strains (R2>0.9), and in the prosthesis micromotions (error<20 μm), giving confidence in the model predictions. The preliminary biomechanical analysis indicated that the strains in the femoral neck are moderately affected by the presence of the prosthesis, apart from localized strain increments that can be considerable, always predicted near the stem. Low micromotions and contact pressure were predicted, suggesting a good stability of the prosthesis. The model accuracy was good in the prediction of the femoral strains and moderately good in the prediction of the bone-prosthesis micromovements. Although the investigated loading conditions were not completely physiological, the preliminary biomechanical analysis showed relatively small changes for the proximal femur after implantation. This validated model can support realistic simulations to examine physiological load configurations and the effects of variations in prosthesis design and implantation technique.
Techniques for Final Pelvic Ring Fixation Based on the Method of Finite Element Modeling