Finite Element Analysis Applied to Bone Remodelling in Revision Arthroplasty of the Femur using Morselized Allograft and Cement

Finite element models have extensively been developed and reported for primary cemented and uncemented total hip replacement, but not for revision arthroplasty of the hip. A two-dimensional equivalent thickness model was developed of the proximal femur with bone grafts, a thin but uniform cement layer and a standard femoral component. This model represents the reconstructed femoral revision setting described by Gie et al (1). The effects of surface texture, cement-stem friction, cement creep and stem malplacement were evaluated. Within the range of coefficients of friction which was investigated in this study (0.03, 0.136 and 0.3) it was observed that the influence of the value of the coefficient upon the stresses in the bone-implant structure are less than 5%. Also static cement creep and certain stem malalignments which were simulated showed a relatively small influence upon the stress distribution within this structure. An agreement between trabecular orientations in the remodeled bone allograft and the principal stress orientations in this structure was observed in the calcar region. It was concluded that the remodelling which occurs in the bone allografts follows Wolff’s law of optimal material use in the trabecular structure.