Summary
The authors present a physico-mathematical model of a human femur, under « monopodal » static constraints, using the finite elements method. Three examples are considered: a normal femur, a femur implanted with a short-stem prosthesis without cement, and a femur implanted with a long-stem prosthesis without cement. The lines of isoconstraints were compared in the three examples, as well as the main constraints (direction and intensity). From the results, the authors suggest that a prosthesis made of titanium is currently best even though its YOUNG's modulus differs from that of the bone. A prosthesis of composite material is possible in the future. While the intensity of the constraints is nearly the same at the level of the epiphysis for the short-stem and long-stem prosthesis it seems that the short-stem prosthesis fitted accurately without cement is the best solution. The introduction of a hip prosthesis modifies the normal curve of the loaded femur by changing the center of this curve.
Résumé
Les auteurs ont procédé à la modélisation physico-mathématique à l'aide de la méthode des éléments finis d'un fémur humain sous contraintes statiques en appui unipodal.
Trois cas de figures ont été retenus: un fémur isolé, un fémur implanté avec une prothèse sans ciment à queue courte, un fémur implanté avec une prothèse sans ciment à queue longue. Les lignes d'isocontraintes ont été comparées dans les trois cas, de mÊme que les contraintes principales en direction et en intensité.
Les auteurs estiment, au vu des résultats, que les prothèses en titane, malgré l'écart entre le module de YOUNG de ces dernières et celui supposé de l'os, sont dans l'état actuel de nos connaissances la meilleure solution en attendant de futures prothèses en un matériau composite qui reste à définir.
Bien que l'intensité des contraintes soit sensiblement identique au niveau de l'épiphyse fémorale proximale dans le cas des prothèses à queue courte et dans celui des prothèses à queue longue, il semble que la meilleure solution soit apportée par des prothèses sans ciment exactement adaptées et munies d'une queue courte.
En effet, l'introduction d'une prothèse de hanche modifie la courbure naturelle du fémur sous chargement en déplaÇant le centre de celle-ci.
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Ferré, J.C., Legoux, R., Marquet, F. et al. A physico-mathematical model for the human femur, with and without a prosthesis, under the static constraints of one-legged stance. Surg Radiol Anat 9, 241–249 (1987). https://doi.org/10.1007/BF02109635
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DOI: https://doi.org/10.1007/BF02109635