Acetabular Component Deformation under Rim Loading Using Digital Image Correlation and Finite Element Methods

Corroboration of coupled musculoskeletal model and finite element predictions with in vivo RSA migration of an uncemented acetabular component

While finite element (FE) models have been used extensively in orthopedic studies, validation of their outcome metrics has been limited to comparison against ex vivo testing. The aim of this study was to validate FE model predictions of the initial cup mechanical environment against patient-matched in vivo measurements of acetabular cup migration using radiostereometric analysis (RSA). Tailored musculoskeletal and FE models were developed using a combination of three-dimensional (3D) motion capture data and clinical computerized tomography (CT) scans for a cohort of eight individuals who underwent primary total hip replacement and were prospectively enrolled in an RSA study. FE models were developed to calculate the mean modulus of cancellous bone, composite peak micromotion (CPM), composite peak strain (CPS) and percentage area of bone ingrowth. The RSA cup migration at 3 months was used to corroborate the FE output metrics. Qualitatively, all FE-predicted metrics followed a similar rank order as the in vivo RSA 3D migration data. The two cases with the lowest predicted CPM (<20 µm), lowest CPS (<0.0041), and high bone modulus (>917 MPa) were confirmed to have the lowest in vivo RSA 3D migration (<0.14 mm). The two cases with the largest predicted CPM (>80 µm), larger CPS (>0.0119) and lowest bone modulus (<472 MPa) were confirmed to have the largest in vivo RSA 3D migration (>0.78 mm). This study enabled the first corroboration between tailored musculoskeletal and FE model predictions with in vivo RSA cup migration. Investigation of additional patient-matched CT, gait, and RSA examinations may allow further development and validation of FE models.

Shell design and reaming technique affect deformation in mobile-bearing total hip arthroplasty acetabular components

Press-fit acetabular components are susceptible to rim deformation. The inherent variability within acetabular reaming techniques may generate increased press-fit and, subsequently, additional component deformation. The purpose of this study was to analyze the insertion and deformation characteristics of acetabular components designed for dual-mobility systems based on component design, size, and reaming technique. Shell deformation was quantified in a validated worst-case scenario foam pinch model. Thin-walled, one-piece, and modular dual-mobility shells of varying size were implanted in under- and over-reamed cavities with insertion force measured and shell deformation assessed using digital image correlation. Increased shell size resulted in larger rim deformation in one-piece components, with a reduction in press-fit by 1 mm resulting in up to 48% reduction in insertion forces and between 23% and 51% reduction in shell deformation. Lower insertion forces and deformations were observed in modular components. Variability in acetabular reaming plays a significant role in the ease of implantation and component deformation in total hip arthroplasty. Modular components are less susceptible to deformation than thin-walled monoblock shells. Care should be taken to avoid excessive under-reaming, particularly in the scenario of large shell size and high-density patient bone stock.

Experimental Validation of Finite Element Models of Intact and Implanted Composite Hemipelvises Using Digital Image Correlation

A detailed understanding of the changes in load transfer due to implantation is necessary to identify potential failure mechanisms of orthopedic implants. Computational finite element (FE) models provide full field data on intact and implanted bone structures, but their validity must be assessed for clinical relevance. The aim of this study was to test the validity of FE predicted strain distributions for the intact and implanted pelvis using the digital image correlation (DIC) strain measurement technique. FE models of an in vitro hemipelvis test setup were produced, both intact and implanted with an acetabular cup. Strain predictions were compared to DIC and strain rosette measurements. Regression analysis indicated a strong linear relationship between the measured and predicted strains, with a high correlation coefficient (R = 0.956 intact, 0.938 implanted) and a low standard error of the estimate (SE = 69.53 με, 75.09 με). Moreover, close agreement between the strain rosette and DIC measurements improved confidence in the validity of the DIC technique. The FE model therefore was supported as a valid predictor of the measured strain distribution in the intact and implanted composite pelvis models, confirming its suitability for further computational investigations.