Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy. The paper published by Oommen et al reviews the essential management strategies for these complex cases. This article explores the integration of finite element analysis (FEA) to enhance surgical precision and outcomes. FEA provides detailed biomechanical insights, aiding in preoperative planning, implant design, and surgical technique optimization. By simulating implant configurations and assessing bone quality, FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy. Advanced imaging techniques, such as 3D printing, virtual reality, and augmented reality, further enhance total hip arthroplasty precision. Future research should focus on validating FEA models, developing patient-specific simulations, and promoting multidisciplinary collaboration. Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes, reduce complications, and enhance quality of life for patients with childhood hip disorder sequelae.

Total hip arthroplasty (THA) is one of the most successful orthopaedic interventions globally, with over 450,000 procedures annually in the U.S. alone. However, issues like aseptic loosening, dislocation, infection and stress shielding persist, necessitating complex, costly revision surgeries. This highlights the need for continued biomaterials innovation to enhance primary implant integrity and longevity. Implant materials play a pivotal role in determining long-term outcomes, with titanium alloys being the prominent choice. However, emerging evidence indicates scope for optimized materials. The nickel-free β titanium alloy Ti-27Nb shows promise with excellent biocompatibility and mechanical properties. Using finite element analysis (FEA), this study investigated the biomechanical performance and safety factors of a hip bone implant made of nickel-free titanium alloy (Ti-27Nb) under actual loading during routine day life activities for different body weights. The FEA modelled physiological loads during walking, jogging, stair ascent/descent, knee bend, standing up, sitting down and cycling for 75 kg and 100 kg body weights. Comparative analyses were conducted between untreated versus 816-hour simulated body fluid (SBF) treated implant conditions to determine in vivo degradation effects. The FEA predicted elevated von Mises stresses in the implant neck for all activities, especially stair climbing, due to its smaller cross-section. Stresses increased substantially with a higher 100 kg body weight compared to 75 kg, implying risks for heavier patients. Safety factors were reduced by up to 58% between body weights, although remaining above the desired minimum value of 1. Negligible variations were observed between untreated and SBF-treated responses, attributed to Ti-27Nb's excellent biocorrosion resistance. This comprehensive FEA provided clinically relevant insights into the biomechanical behaviour and integrity of the Ti-27Nb hip implant under complex loading scenarios. The results can guide shape and material optimization to improve robustness against repetitive stresses over long-term use. Identifying damage accumulation and failure risks is crucial for hip implants encountering real-world variable conditions. The negligible SBF effects validate Ti-27Nb's resistance to physiological degradation. Overall, the study significantly advances understanding of Ti-27Nb's suitability for reliable, durable hip arthroplasties with low revision rates.

The optimal design of complex engineering systems requires tracing precise mathematical modeling of the system's behavior as a function of a set of design variables to achieve the desired design. Despite the success of current tibial components of knee implants, the limited lifespan remains the main concern of these complex systems. The mismatch between the properties of engineered biomaterials and those of biological materials leads to inadequate bonding with bone and the stress-shielding effect. Exploiting a functionally graded material for the stem of the tibial component of knee implants is attractive because the properties can be designed to vary in a certain pattern, meeting the desired requirements at different regions of the knee joint system. Therefore, in this study, a Ti6Al4V/Hydroxyapatite functionally graded stem with a laminated structure underwent simulation-based multi-objective design optimization for a tibial component of the knee implant. Employing finite element analysis and response surface methodology, three material design variables (stem's central diameter, gradient factor, and number of layers) were optimized for seven objective functions related to stress-shielding and micro-motion (including Maximum stress on the cancellous bone, maximum and mean stresses on predefined paths, the standard deviation of mean stress on paths, maximum and mean micro-motions at the bone-implant interface and the standard deviation of mean micro-motion). Then, the optimized functionally graded stem with 6 layers, a central diameter of 5.59 mm, and a gradient factor of 1.31, was compared with a Ti6Al4V stem for various responses. In stress analysis, the optimal stem demonstrated a 1.92% improvement in cancellous bone stress while it had no considerable influence on the maximum, mean, and standard deviation of stresses on paths. In micro-motion analysis, the maximum, mean, and standard deviation of mean micro-motion at the interface were enhanced by 24.31%, 39.53%, and 19.77%, respectively.

The crane hook is a widely utilized component in several industries for the purpose of lifting things. The crane hook must possess the capacity to withstand the intended load without encountering any complications, hence ensuring the safety of both personnel and the objects being lifted. The process of analysis is crucial for the effective utilization of a crane hook. The primary aim of this study was to determine the most efficient cross-sectional crane hook among five distinct geometric profiles. This was achieved through the application of finite element analysis using Solidworks software. Subsequently, the identified cross-sectional profile was further examined using the Python programming language, taking into account the classical equation of a curved beam. The five cross-sectional shapes seen in the study were circular, rectangular, trapezoidal, I-shaped, and T-shaped. For the purposes of this investigation, the chosen material for each cross-sectional crane hook model was 34CrMo4 steel. Despite the identical boundary constraints imposed on all the chosen cross-sectional crane hook profiles, it was observed that the trapezoidal cross-sectional crane hook exhibited superior performance compared to the others. The trapezoidal cross-sectional crane hook model exhibited a Von Mises stress of 203 MPa, with a corresponding factor of safety of 3.20. Further experimentation was conducted using Python to examine the trapezoidal profile. The results indicated that an increased level of parallelism in the inner side of the trapezoidal shape corresponded to a higher factor of safety. Hence, it is advisable to maintain the trapezoidal cross-sectional profile of the crane hook, with due consideration given to maximizing the length of the inner parallel side. The enhancement of design leads to a decrease in the likelihood of failure and the occurrence of undesirable accidents.

Modular hip implants allow intra-operative adjustments for patient-specific customization and targeted replacement of damaged elements without full implant extraction. However, challenges arise from relative micromotions between components, potentially leading to implant failure due to cytotoxic metal debris. In this study magnitude and directions of micromotions at the taper junction were estimated, aiming to understand the effect of variations in head size and neck length. Starting from a reference configuration adhering to the 12/14 taper standard, six additional implant configurations were generated by varying the head size and/or neck length. A musculoskeletal multibody model of a prothesized lower limb was developed to estimate hip contact force and location during a normal walking task. Following the implant assembly, the multibody-derived loads were imposed as boundary conditions in a finite element analysis to compute the taper junction micromotions as the relative slip between the contacting surfaces. Results highlighted the L-size head as the most critical configuration, indicating a 2.81 μm relative slip at the mid-stance phase. The proposed approach enables the investigation of geometric variations in implants under accurate load conditions, providing valuable insights for designing less risky prostheses and informing clinical decision-making processes.

The femur is one of the most important bone in the human body, as it supports the body's weight and helps with movement. The aging global population presents a significant challenge, leading to an increasing demand for artificial joints, particularly in knee and hip replacements, which are among the most prevalent surgical procedures worldwide. This study focuses on hip fractures, a common consequence of osteoporotic fractures in the elderly population. To accurately predict individual bone properties and assess fracture risk, patient-specific finite element models (FEM) were developed using CT data from healthy male individuals. The study employed ANSYS 2023 R2 software to estimate fracture loads under simulated single stance loading conditions, considering strain-based failure criteria. The FEM bone models underwent meticulous reconstruction, incorporating geometrical and mechanical properties crucial for fracture risk assessment. Results revealed an underestimation of the ultimate bearing capacity of bones, indicating potential fractures even during routine activities. The study explored variations in bone density, failure loads, and density/load ratios among different specimens, emphasizing the complexity of bone strength determination. Discussion of findings highlighted discrepancies between simulation results and previous studies, suggesting the need for optimization in modelling approaches. The strain-based yield criterion proved accurate in predicting fracture initiation but required adjustments for better load predictions. The study underscores the importance of refining density-elasticity relationships, investigating boundary conditions, and optimizing models throughin vitrotesting for enhanced clinical applicability in assessing hip fracture risk. In conclusion, this research contributes valuable insights into developing patient-specific FEM bone models for clinical hip fracture risk assessment, emphasizing the need for further refinement and optimization for accurate predictions and enhanced clinical utility.

Ureters are essential components of the urinary system and play a crucial role in the transportation of urine from the kidneys to the bladder. In the current study, a three-dimensional ureter is modelled. A series of peristaltic waves are made to travel on the ureter wall to analyse and measure parameter effects such as pressure, velocity, gradient pressure, and wall shear at different time steps. The flow dynamics in the ureters are thoroughly analysed using the commercially available ANSYS-CFX software. The maximum pressure is found in the triple wave at the ureteropelvic junction and maximum velocity is observed in the single and double wave motion due to the contraction produced by the peristalsis motion. The pressure gradient is maximum at the inlet of the ureter during the single bolus motion. The contraction produces a high jet of velocity due to neck formation and also helps in urine trapping in the form of a bolus, which leads to the formation of reverse flow. Due to the reduction in area, shear stress builds on the ureter wall. The high shear stress may rupture the junctions in the ureter.

Patient-specific dynamic loadings are seldom considered during the evaluation of hip implants. The primary objective of this study is to check for the feasibility of the use of UHMWPE as the material for an acetabular cup o CoCr Alloy that is reported to produce a squeaking sound after replacement. An elliptical shaped stem with three different cross-sectional profiles is considered for simulation. Using a commercial finite element method, patient-specific dynamic forces were applied for the quantitative analysis. The loading and boundary conditions are used as per ISO and ASTM standards. The walking gait cycle is used with two widely used biocompatible materials: titanium and cobalt-chromium. Initially, only the stem is considered for the analysis to finalize the best out of the three profiles, along with the better material for the stem. Later the complete implant is used for the analysis. Profile 1 exhibits 1.25 and 1.17 times greater stress than Profile 2 for CoCr Alloy and Ti-6Al-4V, respectively. Similarly, Profile 3 displays stresses 1.26 and 1.25 times greater than Profile 2 for CoCr Alloy and Ti-6Al-4V, respectively. Comparatively, displacement in stem Profile 2 is 1.75 times higher in Ti-6Al-4V than CoCr Alloy. The full implant displacement at 14% gait cycle is 1.15% higher for the CoCr-acetabular column material combination when compared to UHMWPE. It can be concluded that UHMWPE can be used as the acetabular cup material instead of CoCr for the Profile 2 elliptical shaped hip implant to prevent squeaking after replacement.

Background: Revision hip arthroplasty presents a surgical challenge, necessitating meticulous preoperative planning to avert complications like periprosthetic fractures and aseptic loosening. Historically, assessment of the accuracy of three-dimensional (3D) versus two-dimensional (2D) templating has focused exclusively on primary hip arthroplasty. Materials and Methods: In this retrospective study, we examined the accuracy of 3D templating for acetabular revision cups in 30 patients who underwent revision hip arthroplasty. Utilizing computed tomography scans of the patients' pelvis and 3D templates of the implants (Aesculap Plasmafit, B. Braun; Aesculap Plasmafit Revision, B. Braun; Avantage Acetabular System, Zimmerbiomet, EcoFit 2M, Implantcast; Tritanium Revision, Stryker), we performed 3D templating and positioned the acetabular cup implants accordingly. To evaluate accuracy, we compared the planned sizes of the acetabular cups in 2D and 3D with the sizes implanted during surgery. Results: An analysis was performed to examine potential influences on templating accuracy, specifically considering factors such as gender and body mass index (BMI). Significant statistical differences (p < 0.001) in the accuracy of size prediction were observed between 3D and 2D templating. Personalized 3D templating exhibited an accuracy rate of 66.7% for the correct prediction of the size of the acetabular cup, while 2D templating achieved an exact size prediction in only 26.7% of cases. There were no statistically significant differences between the 2D and 3D templating methods regarding gender or BMI. Conclusion: This study demonstrates that 3D templating improves the accuracy of predicting acetabular cup sizes in revision arthroplasty when compared to 2D templating. However, it should be noted that the predicted implant size generated through 3D templating tended to overestimate the implanted implant size by an average of 1.3 sizes.

Understanding wear mechanisms is a key factor to prevent primary failures causing revision surgery in total hip replacement (THR) applications. This study introduces a wear prediction model of (Polyetheretherketone) PEEK-on-XLPE (cross-linked polyethylene) bearing couple utilized to investigate the wear mechanism under 3D-gait cycle loading over 5 million cycles (Mc). A 32-mm PEEK femoral head and 4-mm thick XLPE bearing liner with a 3-mm PEEK shell are modeled in a 3D explicit finite element modeling (FEM) program. The volumetric and linear wear rates of XLPE liner per every million cycles were predicted as 1.965 mm³/Mc, and 0.0032 mm/Mc respectively. These results are consistent with the literature. PEEK-on-XLPE bearing couple exhibits a promising wear performance used in THR application. The wear pattern evolution of the model is similar to that of conventional polyethylene liners. Therefore, PEEK could be proposed as an alternative material to the CoCr head, especially used in XLPE-bearing couples. The wear prediction model could be utilized to improve the design parameters with the aim of prolonging the life span of hip implants.