Evolution of different designs and wear studies in total hip prosthesis using finite element analysis: A review

Figures & data

Figure 1. The natural hip joint (right hip). (a) Capsule removed anterior aspect, (b) showing the ligament (Chethan, Shyamasunder Bhat et al., 2018; Mattei et al., 2011).

Figure 2. (a) Anterior view (Putz & Pabst, 2006).

Figure 3. The shaft of the femur (Gray, 1960).

Figure 4. Acetabulum (Gray, 1960).

Figure 5. Cross-section of the femur (Gray, 1960; Izzo, 2012b).

Figure 6. Centre of gravity (Gray, 1960).

Table 1. Comparison between textbook references: Active Range of Motion of the Adult hip [in Degrees] (Roach & Miles, 1991; Sankar et al., 2012)

Different range of motions
Hip Flexion	125	115–125	120	120
Hip Extension	10	10–15	30	30
Hip abduction	45	45	45–50	45
Hip internal rotation	45	45	35	45
Hip external rotation	45	45	45	45

Figure 7. Motions of the hip joint (Joumana Medlej, 2014).

Figure 8. Sagittal view of the right hip (Izzo, 2012b; Izzo, 2012a).

Figure 9. Anterior and posterior view of the hip joint (Jones, 2019).

Figure 10. Schematic diagram of a total hip replacement, indicating the different components (Grandjean et al., 2012).

Figure 11. THR revisions (Burger et al., 2007; Ulrich et al., 2008).

Figure 12. THA procedure year-wise (Brittain et al., 2019).

Table 2. Shows some of the finite element analysis studies performed on hip implants

Sl No	Authors	Year	Focus of the study	Observations/ Outcomes
1.	(Maxian et al., 1996a)	1996	Sliding distance coupled finite element formulation for polyethylene wear in total hip arthroplasty.	Wear rates were calculated between the acetabular cup and femoral head and were well within the clinically observed ranges.
2.	(Hall & Unsworth, 1997)	1997	Friction in the hip prosthesis.	Coefficient friction significantly varies the implant life.
3.	(Scifert et al., 1999)	1999	Hip joint dislocation during surgery	The new design showed 28% more resisting moment compared to the traditional implant.
4.	(Watanabe et al., 2000)	2000	Three-dimensional model is used to evaluate the characteristics of the femoral component which is used in resurfacing hip arthroplasty.	The highest stress patterns were noted in the posteroinferior region near the rim of the prosthesis.
5.	(Gross & Abel, 2001)	2001	Finite element analysis of hollow stemmed hip prosthesis is performed to know the stress shielding in the femur.	Hollow stemmed shown the better results over cemented stems.
6.	(Teoh et al., 2002)	2002	Polyethylene linear wear is estimated using a finite element method.	The coefficient of friction does not affect the linear wear rate.
7.	(Tai et al., 2003)	2003	FEM analysis for the stemless femoral prosthesis.	No obvious difference in von Mises stress distribution for the cervico-trochanteric implanted model with two or three fixation screws was observed.
8.	(Wu et al., 2003)	2003	Wear the behavior of hip implants using the FEM method.	The calculated linear wear rates were well within the clinical observations.
9.	(Bevill et al., 2005)	2005	Estimated the linear wear using the Finite element technique.	Greater creep penetration was found with smaller heads, thicker liners, and larger clearance.
10.	(Kayabasi & Erzincanli, 2006)	2006	Evaluated new hip implants using a finite element technique with varying stem cross-sections.	The notched stem has the best results under static conditions.
11.	(Kayabasi & Ekici, 2007)	2007	Shape optimization of hip implant using the finite element technique.	The optimum shape results have better behavioral characteristic than Charnley shapes
12.	(Senalp et al., 2007)	2007	Fatigue behavior of hip implants with varying cross-sections using the finite element technique.	The shape of the stems affects the performance of the implants.
13.	(F. Liu et al., 2008)	2008	Computational wear simulation of metal-on-metal hip implants.	The wear prediction from the computational model matches with the simulator wear results.
14.	(Cilingir, 2010)	2010	Studied the contact mechanics of ceramic on the ceramic hip implants using FEM.	Stress shielding in the resurfaced femur appears to be a major concern
15.	(Shaik et al., 2012)	2012	The durability of hip implants is carried out using the finite element method.	Maximum stresses found to be near the neck region.
16.	(Zhang et al., 2013)	2013	Wear and fatigue of modular hip implants using FEM.	Co–28Cr–6Mo/ DMLS Ti–6Al–4 V superior over Co–28Cr–6Mo/forged Ti–6Al–4 V as a material combination of steam and head.
17.	(Queiroz et al., 2013)	2013	Numerical simulations performed with acetabular cups at tilt angles of 30°, 45°, and 60°	The linear wear rate found to be less for 45° tilt angle.
18.	(Uddin & Zhang, 2013)	2013	Wear prediction of the hard-on-hard hip prosthesis using FEM.	The wear rate found in the study were closely matched with clinical and simulator wear results.
19.	(Alvarez-Vera et al., 2014)	2014	Using FEM studies the edge load contact stress in hip resurfacing.	Minor changes in the conventional design affect the range motion, stress contact, and wear response.
20.	(Lee et al., 2014)	2014	Studied the effect of neck length for ceramic hip implants using FEM.	The short-neck design has a greater potential risk of ceramic failure than longer necks.
21.	(Dyrkacz et al., 2014)	2015	Studied the micro motions in the head taper interface of the modular hip prosthesis during the assembly process using FEA.	With an increase in the head size, assembly force, and taper size the micromotions found to be increased.
22.	(Lin et al., 2016)	2016	Studied the wear in the acetabular cup using the finite element approach.	THR with larger abduction angles tends to produce a deeper depth of wear.
23.	(Fallahnezhad et al., 2017)	2017	Damage at the taper head junction is studied using finite element simulations	The lost area does not have a linear relationship with the mismatch angle of taper junctions.
24.	(Ashkanfar et al., 2017)	2017	Using the finite element method the effect of taper mismatch on wear rate is studied.	Taper mismatch results in higher wear rates.
25.	(Katz et al., 2018)	2018	The patient-specific hip implant is studied using FEM.	Computer tomography-based finite element models can reliably determine strains on the femur surface.
26.	(Bitter et al., 2018)	2018	Wear prediction at the taper interface of modular hip implants is performed using a finite element method.	The results found to be similar to the experimental data.
27.	(Chethan, Zuber, Bhat, Shenoy et al., 2019)	2019	Studied the different stem designs using finite element analysis.	CoC implants exhibited better mechanical properties over the conventional CoPE materials such as UHMWPE.
27.	(Y. Peng et al., 2019)	2019	Polyethylene wear in the hip implant is estimated using a finite element method.	Acetabular component orientation is one of the main factors which affects the wear rate.
28.	(Bechstedt et al., 2020)	2020	Using FEM contact conditions at the taper interface of the hip implant with different loading conditions is studied.	Contact area, plastic (permanent) deformation and contact pressure increased with increasing assembly loads and deeper micro groves.
29.	(Babić et al., 2020)	2020	The fatigue life assessment of hip implant using the finite element method	High tensile stresses occur on the distal region of the femoral component shaft on the anterior lateral side.
Trunnion issues
30.	(Harris, 2012)	2012	Analyzed the effect of edge loading on wear rate in trunnion junction	Edge loading does not increase the wear in the trunnion junction.
31.	(Elkins et al., 2014)	2014	Linear wear rate with change in head size is studied using FEM	Linear wear rate increased with an increase in the head diameter.
32.	(Lavernia et al., 2015)	2015	Studied the correlation between head size and stresses using FEM	Stresses at the trunnion junction tend to increase with an increase in the femoral head size and also this leads to a higher wear rate with an increase in the head size.
33.	(Tan et al., 2015)	2015	The effect of different taper sizes was analyzed after retrieval from the patient.	11/13 mm taper performed worst compared to 12/14 mm taper
34.	(Bhalekar et al., 2019)	2019	Using a hip simulator wear rate was determined for ceramics trunnion and titanium trunnion	Ceramic trunnions had less wear compared to titanium trunnions
34.	(Norman et al., 2019)	2019	The effect of different head sizes for the stresses developed in the taper trunnion interface is studied using FEM.	Stresses at the trunnion junction tend to increase with an increase in the femoral head size.
35.	(Chethan K N et al., 2020)	2020	Studied the wear rate in trunnion interface with change in taper geometry	Found that there are no significant changes in the linear wear rate at the taper junction with a change in the taper geometry.
36.	(Chethan et al., 2021)	2021	The effect of change in neck length in circular-shaped hip stem with change in femoral head sizes is studied using FEA.	The change in neck length does not significantly affect the performance of the hip implant. However, a reduction in neck length leads to the dislocation of implants.

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