1 Interdisciplinary Graduate School of Engineering and Sciences, Kyushu University, Fukuoka, Japan. 2 Fakulti Kejuruteraan Mekanikal, Universiti Teknologi MARA, Shah Alam, Malaysia. 3 Research Institute for Applied Mechanics, Kyushu University, Fukuoka, Japan.
Gait disorders contribute to the risk of falls and successive injuries, especially to elderly populations. The risk of falls becomes higher for hip osteoarthritis (OA) and hip arthroplasties patients due to poor balancing and gait impairment. Bone adaptation and bone loss are fundamental issues in considering the changes of bone behavior and gait pattern. In this study, computational analysis of the lower limbs was conducted to estimate the bone adaptation after hip arthroplasties procedure. 3D inhomogeneous model of lower limb was developed from computed topography (CT- based) data of 79 years old patient with hip osteoarthritis problem in left limb. Two types of arthroplaties were constructed in the left limb, namely total hip arthroplasty and resurfacing hip arthroplasty using commercial biomedical software, Mechanical Finder v6.1. Prosthesis stem and acetabular cup of THA were modelled as titanium alloy material (E = 114 GPa, v = 0.34), femoral ball and bearing insert as alumina properties (E = 370 GPa, v = 0.22). Meanwhile, RHA implant was assigned as Co-Cr-Mo material (E = 230 GPa, v = 0.30). Contact between both implants and bone were considered to be perfectly bonded at the interface. A load case of quiet standing position was conducted in this analysis with 60 kg of the patients’ body weight. The load was applied at the cross sectional lumbar vertebra and fixed at the distal of femoral shafts. Results show different patterns of stress distribution in right and left (operated) limbs for hip OA, THA and RHA models. An indication of stress alteration on both limbs after arthroplasties suggested that the bone adaptation occurred. The higher percentage of change in the left limb projected that the adaptation was more critical in operated limb.
Abdullah, A. , Mitsugu Todo, M. (2015) Effects of Hip Arthroplasties on Bone Adaptation in Lower Limbs: A Computational Study. Journal of Biosciences and Medicines, 3, 1-7. doi: 10.4236/jbm.2015.34001.
[1] Marker, D.R., Strimbu, K., McGrath, M.S., Zywiel, M.G. and Mont, M.A. (2009) Resurfacing versus Conventional Total Hip Arthroplasty: Review of Comparative Clinical and Basic Science Studies. Bulletin of the NYU Hospital for Joint Diseases, 67, 120-127. [2] Joshi, M., Advani, S., Miller, F. and Santare, M. (2000) Analysis of a Femoral Hip Prosthesis Designed to Reduce Stress. Journal of Biomechanics, 33, 1655-1662. http://dx.doi.org/10.1016/S0021-9290(00)00110-X [3] Boyle, C. and Kim, I.Y. (2011) Comparison of Different Hip Prosthesis Shapes Considering Micro-Level Bone Remodeling and Stress-Shielding Criteria Using Three-Dimensional Design Space Topology Optimization. Journal of Biomechanics, 44, 1722-1728. http://dx.doi.org/10.1016/j.jbiomech.2010.11.029 [4] Nantel, J., Termoz, N., Vendittoli, P.A., Lavigne, M. and Prince, F. (2009) Gait Patterns after Total Hip Arthroplasty and Surface Replacement Arthroplasty. Arch Phys Med Rehabil, 90, 463-469. http://dx.doi.org/10.1016/j.apmr.2008.08.215 [5] Kiss, R.M. (2010) Effects of Walking Speed and Severity of Hip Osteoarthritis on Gait Variability. Journal of Electromyography and Kinesiology, 20, 1044-1051. http://dx.doi.org/10.1016/j.jelekin.2010.08.005 [6] Holnapy, G., Iiiyes, A. and Kiss, R.M. (2013) Impact of the Method of Exposure in Total Hip Arthroplasty on the Variability of Gait in the First 6 Months of the Postoperative Period. Journal of Electromyography and Kinesiology, 23, 966-976. http://dx.doi.org/10.1016/j.jelekin.2013.01.005 [7] Bennet, D., Ogonda, L., Ellitt, D., Humphreys, L., Lawlor, M. and Beverland, D. (2007) Comparison of Immediate Postoperative Walking Ability in Patients Receiving Minimally Invasive and Standard-Incision Hip Arthroplasty. Journal of Arthroplasty, 22, 490-495. http://dx.doi.org/10.1016/j.arth.2006.02.173 [8] Dujardin, F., Aucouturier, T., Bocquet, G., Dupare, F., Weber, J. and Thormine, J.M. (1998) Kinematics of the Healthy and Arthritic Hip Joint during Walking. A Study of 136 Subjects. Rev Chir Orthop Reparatrice Appar Mot, 84, 689- 699. [9] Keyak, J.H., Skinner, H.B. and Fleming, J.A. (2001) Effect of Force Direction on Femoral Fracture Load for Two Types of Loading Conditions. J Orthop Res, 19, 539-544. http://dx.doi.org/10.1016/S0736-0266(00)00046-2 [10] Recnik, G., Kralj-Iglic, V., Iglic, A., Antolic, V., Kramberger, S. and Vengust, R. (2007) Higher Peak Contact Hip Stress Predetermines the Side of Hip Involved in Idiopathic Osteoarthritis. Clinical Biomechanics, 22, 1119-1124. http://dx.doi.org/10.1016/j.clinbiomech.2007.08.002 [11] Van Rietbergen, B., Huiskes, R., Weinans, H., Sumner, D.R., Turner, T.M. and Galante, J.O. (1993) The Mechanism of Bone Remodeling and Resorption around Press-Fitted THA Stems. Journal of Biomechanics, 26, 369-382. http://dx.doi.org/10.1016/0021-9290(93)90001-U [12] Teichtahl, A.J., Wang, Y., Smith, S., Wluka, A.E., Giles, G.G., Bennell, K.L., O’Sullivan, R. and Cicuttini, F.M. (2014) Structural Changes of Hip Osteoarthritis using Magnetic Resonance Imaging. Arthritis Research & Therapy, 16, 466- 475. http://dx.doi.org/10.1186/s13075-014-0466-4 [13] Beaulieu, M.L., Lamontagne, M. and Beaule, P.E. (2010) Lower Limb Biomechanics during Gait Do Not Return to Normal Following Total Hip Arthroplasty. Gait and Posture, 32, 269-273. http://dx.doi.org/10.1016/j.gaitpost.2010.05.007 [14] Abdullah, A.H., Jaafar, E.F., Nasir, N., Abdul Latip, E.N. and Tardan, G. (2011) Influences of Prosthesis Stem Lengths in Cementless Total Hip Arthroplasty. Applied Mechanics and Materials, 52-54, 2088-2093. http://dx.doi.org/10.4028/www.scientific.net/AMM.52-54.2088 [15] Chung, C.Y., Park, M.S., Lee, K.M., Lee, S.H., Kim, T.K., Kim, K.W., Park, J.H. and Lee, J.J. (2010) Hip Osteoarthritis and Risk Factors in Elderly Korean Population. Osteoarthritis and Cartilage, 18, 312-316. http://dx.doi.org/10.1016/j.joca.2009.11.004 [16] Ringsberg, K., Gerdhem, P., Johansson, J. and Obrant, K.J. (1999) Is There a Relationship between Balance, Gait Performance and Muscular Strength in 75-Year-Old Women? Age and Aging, 28, 289-293. http://dx.doi.org/10.1093/ageing/28.3.289