4.5 Article

Application of Novel Design Bone Grafting for Treatment of Segmental Acetabular Rim Defects During Revision Total Hip Arthroplasty

Journal

JOURNAL OF BIONIC ENGINEERING
Volume 18, Issue 6, Pages 1369-1377

Publisher

SPRINGER SINGAPORE PTE LTD
DOI: 10.1007/s42235-021-00097-6

Keywords

Segmental defects of the acetabular rim; Bone grafting; Finite element analysis method; Structure optimization; Revision total hip arthroplasty

Funding

  1. National Natural Science Foundation of China [82072456, 81802174]
  2. National Key R&D Program of China [2018YFB1105100]
  3. Bethune plan of Jilin University [419161900014]
  4. Wu Jieping Medical Foundation [3R119C073429]
  5. Department of Science and Technology of Jilin Province, P.R.C. [20200404202YY, 20200201453JC]
  6. Department of Finance in Jilin province [2019SCZT046, 2020SCZT037]
  7. undergraduate teaching reform research project of Jilin University [4Z2000610852]
  8. key training plan for outstanding young teachers of Jilin University [419080520253]
  9. Jilin Province Development and Reform Commission, P.R.C. [2018C010]
  10. Natural Science Foundation of Jilin Province [20200201345JC]

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The study developed efficient techniques for treating acetabular bone deficiency using novel graft structures. The Finite Element Analysis (FEA) model, based on a healthy patient without any peri-acetabular bony defect, was used to evaluate the mechanical performances of different grafts. Among the structures, the mortise-tenone structure was found to provide better relative micromotion and suitable biomechanical properties, making it the optimal treatment option for acetabulum reconstruction.
The study aimed to develop efficient techniques with different novel graft structures to enhance the treatment of acetabular bone deficiency. The inhomogeneous material properties Finite Element Analysis (FEA) model was reconstructed according to computed tomography images based on a healthy patient without any peri-acetabular bony defect according to the American Academy of Orthopedic Surgeons (AAOS). The FEA model of acetabular bone deficiency was performed to simulate and evaluate the mechanical performances of the grafts in different geometric structures, with the use of fixation implants (screws), along with the stress distribution and the relative micromotion of graft models. The stress distribution mainly concentrated on the region of contact of the screws and superolateral bone. Among the different structures, the mortise-tenone structure provided better relative micromotion, with suitable biomechanical property even without the use of screws. The novel grafting structures could provide sufficient biomechanical stability and bone remodeling, and the mortise-tenone structure is the optimal treatment option for acetabulum reconstruction.

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