Impaction Loads Resulting in Intraoperative Periprosthetic Femoral Fracture: A Finite Element Study

摘要

Intraoperative periprosthetic femoral fractures (IPPFF) occur in approximately 3-5% of all cementless total hip arthroplasty (THA) surgeries. This study aimed to identify the critical impaction load to cause an IPPFF during implant implementation. This critical load may be used as a guideline for surgeons as well as a parameter for the design of future surgical tools and procedures. This study concerned a single femur of a healthy 60 year old female with an anatomical femoral stem implant, thus the effects of patient specific variables (such as osteoporosis, amount of bone resorption, bone damage, implant geometry, age and gender) were not considered. The eXtended Finite Element Method (XFEM) was used to analyse the fracture. From CT scan data, a user-defined subroutine is used to assign heterogeneous isotropic material properties to the femur. It was computed that IPPFF would take place at an impaction load of 18.5 kN.