Altered load transfer in the pelvis in the presence of periprosthetic osteolysis

• Published in: Journal of biomechanical engineering Vol. 136; no. 11
• Main Authors: Munro, Jacob T, Fernandez, Justin W, Millar, James S, Walker, Cameron G, Howie, Donald W, Shim, Vickie B
• Format: Journal Article
• Language: English
• Published: United States 01.11.2014
• Subjects: Aged; Arthroplasty, Replacement, Hip - adverse effects; Finite Element Analysis; Gait; Humans; Male; Osteolysis - diagnostic imaging; Osteolysis - physiopathology; Pelvic Bones - diagnostic imaging; Pelvic Bones - physiopathology; Postoperative Complications - diagnostic imaging; Postoperative Complications - physiopathology; Stress, Mechanical; Tomography, X-Ray Computed; Weight-Bearing
• ISSN: 1528-8951
• DOI: 10.1115/1.4028522

Periprosthetic osteolysis in the retroacetabular region with cancellous bone loss is a recognized phenomenon in the long-term follow-up of total hip replacement. The effects on load transfer in the presence of defects are less well known. A validated, patient-specific, 3D finite element (FE) model of the pelvis was used to assess changes in load transfer associated with periprosthetic osteolysis adjacent to a cementless total hip arthroplasty (THA) component. The presence of a cancellous defect significantly increased (p < 0.05) von Mises stress in the cortical bone of the pelvis during walking and a fall onto the side. At loads consistent with single leg stance, this was still less than the predicted yield stress for cortical bone. During higher loads associated with a fall onto the side, highest stress concentrations occurred in the superior and inferior pubic rami and in the anterior column of the acetabulum with larger cancellous defects.