Bone mineral density changes around the stem correlate with stress changes after total hip arthroplasty: A study using thermoelastic stress analysis

Author:

Watanabe Ryunosuke1ORCID,Mishima Hajime1,Takehashi Hironori1,Wada Hiroshi1,Totsuka Sho1,Nishino Tomofumi1,Yamazaki Masashi1

Affiliation:

1. Department of Orthopaedic Surgery, Institute of Medicine University of Tsukuba Tsukuba Japan

Abstract

AbstractPurposeThermoelastic stress analysis (TSA) was used to evaluate stress changes over the entire surface of a specimen. This study aimed to assess the relationship between femoral stress distribution, analysed using TSA and changes in bone mineral density (BMD) after total hip arthroplasty (THA).MethodsStress changes in the simulated bone before and after taper‐wedge stem insertion were measured using the TSA. Stress changes were compared with BMD changes around the stem 1 year after surgery in a THA patient (58 hips) with the same taper‐wedge stem. Subsequently, we compared the correlation between stress changes and BMD changes.ResultsTSA revealed significant stress changes before and after stem insertion, with prominent alterations in the proximal medial region. The BMD changes at 1 year post‐THA exhibited a 15%–25% decrease in the proximal zones, while Zones 2–6 showed a −6% to 3% change. Notably, a strong positive correlation (0.886) was found between the stress change rate and BMD change rate.ConclusionsThis study demonstrated a high correlation between femoral stress distribution assessed using TSA and subsequent BMD changes after THA. The TSA method offers the potential to predict stress distribution and BMD alterations postsurgery, aiding in implant development and clinical assessment. Combining TSA with finite element analysis could provide even more detailed insights into stress distribution.Level of EvidenceCase series (with or without comparison).

Publisher

Wiley

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