The effect of rotational degree and routine activity on the risk of collapse in transtrochanteric rotational osteotomy for osteonecrosis of the femoral head—a finite element analysis
| Autor: | Deng Yuping, Wang Mian, Hanbin Ouyang, Yang Yang, Pusheng Xie, Jinchuan Tan, Wenhua Huang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0206 medical engineering Finite Element Analysis Biomedical Engineering Transtrochanteric rotational osteotomy 02 engineering and technology Walking 03 medical and health sciences Femoral head 0302 clinical medicine Femur Head Necrosis Risk Factors medicine Humans Postoperative Period Risk of collapse Collapse (medical) Orthodontics Rotational degree 030222 orthopedics Preoperative planning business.industry 020601 biomedical engineering Finite element method Computer Science Applications Biomechanical Phenomena Femoral Neck Fractures Osteotomy medicine.anatomical_structure Osteonecrosis of the femoral head Surgery Computer-Assisted Correlation analysis Fracture (geology) Routine activity Original Article medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | Medical & Biological Engineering & Computing |
| ISSN: | 1741-0444 0140-0118 |
| Popis: | To explore the mechanical mechanism and provide preoperative planning basis for transtrochanteric rotational osteotomy (TRO) procedure, a joint-preserving procedure for osteonecrosis of the femoral head. Eleven TRO finite element femurs with the most common types of necrosis were analyzed under multi-loading conditions. Thereafter, we made a comprehensive evaluation by considering the anatomy characters, daily activities, and risk indicators contain necrosis expansion trend, necrotic blood supply pressure, and the risk of fracture. The risk of fracture (ROF) is the lowest when standing on feet and increases gradually during normal walking and walking upstairs and downstairs. Compared with posterior rotation, rotating forward keeps more elements at low risk. Additionally, the correlation analysis shows it has a strong negative correlation (R2 = 0.834) with the average modulus of the roof. TRO finally decreased the stress and energy effectively. However, the stress and strain energy arise when rotated posteriorly less than 120°. The comprehensive evaluation observed that rotating forward 90°could reduce the total risks to 64%. TRO is an effective technique to prevent collapse. For the anterior and superior large necrosis, we recommend to rotate forward 60° to 90° (more efficient) or backward 180°. The methodology followed in this study could provide accurate and personalize preoperative planning. Graphical AbstractA proximal femur was reconstructed and modified using Mimics from a series of computed tomography. The models were meshed after solidified and performed different osteotomy, and then assigned material based on the Hounsfield Unit from CT images. Finally, 44 different TRO finite element femurs were analyzed under multi-loading conditions and evaluated comprehensively. |
| Databáze: | OpenAIRE |
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