ACETABULAR LOAD-TRANSFER AND MECHANICAL STABILITY: A FINITE ELEMENT ANALYSIS COMPARING DIFFERENT CEMENTLESS SOCKETS

Abstract

Acetabular stress shielding may be a failure mechanism of acetabular constructs promoting osteolysis, aseptic loosening and failure. We used three-dimensional finite element analysis (FEA) to evaluate the effect of flexible sockets on acetabular stress shielding. The sockets were made of (1) full polyethylene (PE), (2) PE with a metal bearing and (3) a PE insert with a metal backing was used as a traditional stiff implant. We compared the strain energy density and interfacial micro-motions between bone and cementless sockets during walking. In our FEA model, the most elastic socket (case 1) showed the highest levels of micro-motion during walking (400 μm). The most rigid socket (case 3) showed smaller areas of high micro-motions. Assuming a threshold for ingrowth of 50 microns, the flexible cup showed an ingrowth area of almost 40%, whereas the other two cases showed stable areas covering 60% of the total bone–component interface. Furthermore, we found that the introduction of an implant generates a very different strain pattern directly around the implant as compared with the intact case, which has a horse-shoe shaped cartilage layer in the acetabulum. This difference was not affected much by the stiffness of the implant; a more flexible implant resulted in only slightly higher strain levels. Bone strains over 1.5 mm from the cup showed physiological values and were not affected by the stiffness of the implant. Hence, this study shows that the physiological strain patterns are not obtained in the direct periprosthetic bone, regardless of the stiffness of the material.