Australasian Physical & Engineering Sciences in Medicine (2019) 42:1033–1038

https://doi.org/10.1007/s13246-019-00802-0

SCIENTIFIC PAPER

Evaluation of new hip prosthesis design with finite element analysis

Çelik Talip1 · Yasin Kişioğlu1

Received: 20 May 2019 / Revised: 16 September 2019 / Accepted: 17 September 2019 / Published online: 10 October 2019
© Australasian College of Physical Scientists and Engineers in Medicine 2019

Abstract
Cemented and cementless hip prostheses are used in total hip replacement surgery. Short, medium and long term success rates
of these hip prostheses are controversial in the literature. Traditional cemented and cementless hip prostheses have advantages
and disadvantages affecting the success of the implantation process. In this study, a new design of hip prosthesis is presented
considering the advantages and disadvantages of the prostheses. Femur and prostheses were modeled and combined with
each other to perform the finite element analysis (FEA). The new design of prosthesis was compared to the conventional
prosthesis in terms of mechanical aspects. The evaluation criteria are the maximum von Mises stress and micro-movement
of the contact between femur and prosthesis. In conclusion, the new design of prosthesis was found to provide a sufficient
amount of primary stability and decreased the risk of stress shielding.

Keywords Hip prosthesis · Finite element analysis · New hip prosthesis · Computed tomography

Introduction studies argue that the cementless method is more success-

ful [4]. The primary mechanical problem in the cemented
Total hip prosthesis surgery is a successful method that fre- method is aseptic loosening. The main reason for the aseptic
quently used for hip pain relief. An estimated one million loosening in this method is the cement crack [5]. Because
hip prostheses are performed worldwide annually. During cement cracking triggers the emergence of all other prob-
the first ten years of these operations, approximately 5–10% lems. The load was transferred from the prosthesis to femur
of patients is reoperated due to different reasons [1]. Con- through the cement. For this reason, the stresses on the
sidering the numbers, it is seen that there are serious loss cement are very important in the formation of the cement
of material and money and also reducing the quality of the crack. On the other hand, the formation of cement crack
patient’s life. Aseptic loosening, bone resorption, pain, post- is associated with cement thickness [6]. Experimental and
prosthetic bone fractures, and dislocations are the main numerical studies emphasize that the thickness of the cement
causes of this revision. Generally, mechanical problems are should be a minimum of 2 mm for optimum results [7]. In
among the causes of the revision in the short (1 year) and the cementless method, the main problem is the aseptic
middle (5 years) period. These problems are insufficient loosening related to the primary stability of the prosthesis.
implant design, stability, overload, etc.[2]. The insufficient stability causes the aseptic loosening of
There are two methods, cemented and cementless, used in the prosthesis. According to the literature, the formation of
hip surgery. In the cemented method, bone cement is placed osseointegration for the cementless method depends on the
between the bone and the stem and the stem is fixed to the amount of the motion between the bone and the stem [8]. In
femur in this way. In the cementless method, it is fixed by a this study, a new prosthesis design was performed to elimi-
press-fit method which means nailing to the bone. The suc- nate the mentioned problems and it was compared with the
cess rates of these methods are still being discussed. Some traditional one. The aim of this study is to reduce the risk
studies suggest the cemented method [3], while some other of prosthesis failure by modifying the traditional cemented
prosthesis.

* Çelik Talip
[email protected]
1
Department of Biomedical Engineering, Technology
Faculty, Kocaeli University, 41380 Kocaeli, Turkey

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1034 Australasian Physical & Engineering Sciences in Medicine (2019) 42:1033–1038

Materials and methods mesh refinement was applied to the contact regions to get
convergences. Solid 187 tetrahedron element was used
Traditional and new designed prostheses were modeled via for the finite element models. The contact types between
SolidWorks as seen in Fig. 1. Femur model was generated cement and bone, cement and stem and bone and stem
using Computer Tomography (CT) images. The femur and were defined bonded, debonded (frictionless), and fric-
prostheses models were combined in the SolidWorks pro- tional, respectively. The models were applied to static load
gram as in the surgery. The models were transferred to the obtained from the literature for a 700 N weight person
Ansys Workbench software to analyze the system. walking normal speed. Maximum forces resulting from
The material properties of all models were assumed to be walking were applied to the stem head [12]. The muscle
linear, elastic and isotropic. The material properties of the forces were performed as indicated by Duda et al. [13].
femur were defined according to the density that was cal- The distal femur was fixed in three directions as seen in
culated from the CT images [9]. The material properties of (Fig. 2, Table 2).
Titanium Alloy (Ti6Al4V) which the most commonly used
for the prosthesis were described for the prostheses. Poly-
methylmethacrylate (PMMA) was selected for the material
properties of the bone cement (Table1) [10]. The compres-
sive strength of the bone cement is 93 MPa, the elasticity of
the cement is 2130 MPa [11].
Mesh convergence study was performed by refining
the element size from 6 to 2 mm at the 0.5 mm inter-
val for the femur, 4 to 1 mm at 0.25 mm interval for the
prosthesis and 2 to 0.5 mm at 0.25 mm interval for the
cement models. The most appropriate element sizes for
the optimum results were specified as 4, 1.5 and 0.75 mm
for the femur, stem, and cement, respectively. Additional

Fig. 2  (a) Finite element model of femur-stem system, and (b) loads
Fig. 1  Traditional and new designed prostheses models and boundary condition

Table 1  The material properties Materials Density (g/cm3) Modulus of elasticity (MPa) Poison ratio
of the models [9, 10]
Prosthesis Ti6Al4V 4.4 113,000 0.33
Femur Bone 𝜑 = 1.067 × HU + 131 E = 0.004 × 𝜑2.01 0.3
Bone cement PMMA 1.18 2130 0.3
3
HU hounsfield unit, φ density (g/cm )

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Table 2  Load values used in finite element analysis [12, 13]

Force (N) Fx Fy Fz Fresultant

Hip joint 378 230 1603 1669.2

Abductors − 406 − 30.1 − 605.5 729.7
Vastus leteralis 6.3 129.5 650.3 663.1
Tensor fascia latae lateral part 3.5 4.9 133 133.2
Tensor fascia latae proksimal − 50.4 − 81.2 − 92.4 132.9
part

Results

Validation of the FEA models

The strain values predicted by current FEA for femur under

loading conditions are similar to the experimental study
[14]. The difference rate between FEA results and experi-
mental studies are found an average of 4.5%. Besides, FEA
Fig. 3  von Mises stresses on the prostheses. (a) Traditional cemented
results from the current study are similar to the FEA studies stem (b) new designed prosthesis
in the literature [15, 16].
Two criteria were selected to determine the FEA results
according to the literature [15]. One of them is the von Mises the maximum stress results were obtained in the proximal
stresses to evaluate the strength of the prosthesis and cement. part of the cement for the new designed prosthesis. The
The other criterion is the axial normal strain distributions maximum stress values were calculated 32.1 MPa for the
of the proximal femur to examine the stress shielding [16]. traditional prosthesis and 11.1 MPa for the new designed
prosthesis.
von Mises stresses on the prostheses

The maximum von Mises stresses were obtained on the new The equivalent strain distribution on the femur
designed prosthesis as seen in Fig. 3. The maximum stresses
occurred in the distal region of the traditional prosthesis. 7 points were created for each region determined on the
The maximum stresses were calculated in the middle region femur. The strain values were calculated at these points.
of the new designed prosthesis due to stress concentration. These values were carried out to investigate the distribution
The sharp edges of the new prosthesis were increased the of the load transfer in the femur after the stem placement
von Mises stress on the prosthesis. However, the yield and to observe the load transfer of these distributions in dif-
strength of the material is higher than the obtained stress ferent prostheses. This criterion is an important parameter
values of both prostheses. For this reason, the mechanical for studying the stress shielding and bone destruction in the
failure of prostheses is not expected. If the sharp edges can femur after placement [17].
be smoothed, the von Mises stress on the newly designed The highest compressive strain values were calculated on
prostheses is reduced. the intact (non-surgical) femur as seen in Fig. 5. The refer-
ence graph is the intact femur’s graph. The higher strain
von Mises stresses on the cement value causes more bone density according to Wolff’s Law
[17]. Hence, more strain gives better results for a prosthesis.
The stress distributions of the cement were given in Fig. 4. The strain values were decreased as a result of traditional
The cement for traditional prosthesis has higher stress val- and the new designed prostheses insertion, especially on the
ues than the new designed prosthesis. The risk of failure traditional prosthesis. The negative values in Fig. 5 dem-
is higher in the cement used for the traditional prosthesis. onstrate the compressive strain, the positive values demon-
Because the cement for the traditional prosthesis is between strate the tensile strength. The strain values on the femur
the bone and prosthesis. Thus, the forces acting on the pros- that inserted the new designed prosthesis were obtained
thesis transferred to the femur throughout the cement. The higher than the traditional one. Hence, the new designed
cement stresses in the traditional prosthesis are concentrated prosthesis has more advantages compared with the tradi-
in the distal part of the cement as seen in Fig. 4a. However, tional prosthesis. As a result, the new designed prosthesis

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1036 Australasian Physical & Engineering Sciences in Medicine (2019) 42:1033–1038

Fig. 4  von Mises stresses on the

cement mantles. (a) Cement for
traditional stem (b) cement for
new designed prosthesis

Fig. 5  The equivalent strain 40

values on the femur
30

20
Axial Normal Strain (10-4)

10

0
0 1 2 3 4 5 6 7 8 9 10 11

-10

-20 Conventional Cemented

Prosthesis
New Design Prosthesis
-30
Intact Femur

-40
Points

was increased the strain values on the femur that prevent the load transfer changes when the hip prosthesis is inserted in
stress shielding. the femur. The load in the proximal femur is decreased and
this situation causes the bone weakening. This event, which
is also called stress shielding, results in excessive weaken-
Discussion ing of the bone, loosening of the prosthesis and removal of
the prosthesis. For these reasons, many design studies have
The determination of the proper method for the surgeon been carried out on traditional prosthesis designs [18-20].
(cemented and cementless) is still unclear. The effects of In this study, the new prosthesis design that combines the
the cement usage were evaluated in the previous study [15]. advantages of two different methods (cemented and cement-
According to the study, the cement usage was reduced to less) used in the hip prosthesis placement is presented and
stress shielding and aseptic loosening risk. However, the this design is compared with traditional design.
cement crack is an important problem for the cemented The risk of cement cracking is the most important prob-
method. Hence, the advantages of both cemented and lem in cemented hip prostheses [1, 15]. Since the bone
cementless methods were combined for the best results. In cement is placed between the bone and the prosthesis, the
this study, the new hip prosthesis was designed according load transfer is transferred from the prosthesis to the cement
to this perspective. and from the cement to the bone. The transferred load from
Most of the problem that arises in the traditional hip pros- the prosthesis, which has a higher elastic modulus, to the
thesis designs are due to mechanical reasons. The load trans- cement material that elastic modulus was lower than pros-
fer in the intact femur is from the outer region of the femur thesis material increases the risk of cement crack. The rapid
(cortical bone) to the distal end of the femur. However, this integration of the bone with cement eases the insertion of the

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