000150487 001__ 150487
000150487 005__ 20251017144638.0
000150487 0247_ $$2doi$$a10.1016/j.clinbiomech.2017.07.005
000150487 0248_ $$2sideral$$a100753
000150487 037__ $$aART-2017-100753
000150487 041__ $$aeng
000150487 100__ $$0(orcid)0000-0002-8503-9291$$aCilla, M.
000150487 245__ $$aFemoral head necrosis: A finite element analysis of common and novel surgical techniques
000150487 260__ $$c2017
000150487 5060_ $$aAccess copy available to the general public$$fUnrestricted
000150487 5203_ $$aBackground Femoral head necrosis is a common cause of secondary osteoarthritis. At the early stages, treatment strategies are normally based on core decompression techniques, where the number, location and diameter of the drilling holes varies depending on the selected approach. The purpose of this study was to investigate the risk of femoral head, neck and subtrochanteric fracture following six different core decompression techniques. Materials Five common and a newly proposed techniques were analyzed in respect to their biomechanical consequences using finite element analysis. The geometry of a femur was reconstructed from computed-tomography images. Thereafter, the drilling configurations were simulated. The strains in the intact and drilled femurs were determined under physiological, patient-specific, muscle and joint contact forces. Findings The following results were observed: i) - an increase in collapse and fracture risk of the femur head by disease progression ii) - for a single hole approach at the subtrochanteric region, the fracture risk increases with the diameter iii) - the highest fracture risks occur for an 8 mm single hole drilling at the subtrochanteric region and approaches with multiple drilling at various entry points iv) - the proposed novel approach resulted in the most physiological strains (closer to the experienced by the healthy bone). Interpretation Our results suggest that all common core decompression methods have a significant impact on the biomechanical competence of the proximal femur and impact its mechanical potential. Fracture risk increases with drilling diameter and multiple drilling with smaller diameter. We recommend the anterior approach due to its reduced soft tissue trauma and its biomechanical performance.
000150487 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000150487 590__ $$a1.863$$b2017
000150487 591__ $$aENGINEERING, BIOMEDICAL$$b47 / 77 = 0.61$$c2017$$dQ3$$eT2
000150487 591__ $$aSPORT SCIENCES$$b41 / 81 = 0.506$$c2017$$dQ3$$eT2
000150487 591__ $$aORTHOPEDICS$$b38 / 77 = 0.494$$c2017$$dQ2$$eT2
000150487 592__ $$a0.982$$b2017
000150487 593__ $$aBiophysics$$c2017$$dQ1
000150487 593__ $$aOrthopedics and Sports Medicine$$c2017$$dQ1
000150487 593__ $$aSports Science$$c2017$$dQ2
000150487 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000150487 700__ $$aCheca, S.
000150487 700__ $$aPreininger, B.
000150487 700__ $$aWinkler, T.
000150487 700__ $$aPerka, C.
000150487 700__ $$aDuda, G.N.
000150487 700__ $$aPumberger, M.
000150487 773__ $$g48 (2017), 49-56$$pClin. biomech.$$tClinical Biomechanics$$x0268-0033
000150487 8564_ $$s5320073$$uhttps://zaguan.unizar.es/record/150487/files/texto_completo.pdf$$yPostprint
000150487 8564_ $$s2425484$$uhttps://zaguan.unizar.es/record/150487/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000150487 909CO $$ooai:zaguan.unizar.es:150487$$particulos$$pdriver
000150487 951__ $$a2025-10-17-14:30:18
000150487 980__ $$aARTICLE