The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study
Objective The alteration in the mechanical environment of the necrotic area is the primary cause of the collapse observed in osteonecrosis of the femoral head (ONFH). This study aims to evaluate the biomechanical implications of the China‐Japan Friendship Hospital (CJFH) classification system and hi...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-10-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13865 |
| _version_ | 1827799831053074432 |
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| author | Ming‐Tao Wen Xue‐Zhen Liang Di Luo Jia‐Cheng Li Bo‐Zhao Yan Bo‐Wen Lu Yan‐Bo Guo Bo Xu Gang Li |
| author_facet | Ming‐Tao Wen Xue‐Zhen Liang Di Luo Jia‐Cheng Li Bo‐Zhao Yan Bo‐Wen Lu Yan‐Bo Guo Bo Xu Gang Li |
| author_sort | Ming‐Tao Wen |
| collection | DOAJ |
| description | Objective The alteration in the mechanical environment of the necrotic area is the primary cause of the collapse observed in osteonecrosis of the femoral head (ONFH). This study aims to evaluate the biomechanical implications of the China‐Japan Friendship Hospital (CJFH) classification system and hip flexion angles on the necrotic area in ONFH using finite element analysis (FEA). The goal is to provide valuable guidance for hip preservation treatments and serve as a reference for clinical diagnosis and therapeutic interventions. Methods Hip tomography CT scan data from a healthy volunteer was used to create a 3D model of the left hip. The model was preprocessed and imported into Solidworks 2018, based on the CJFH classification. Material parameters and boundary conditions were applied to each fractal model in ANSYS 21.0. Von Mises stresses were calculated, and maximum deformation values were obtained to evaluate the biomechanical effects of the load on the necrotic area and post‐necrotic femur, as well as assess each fractal model's collapse risk. Results (1) At the same hip flexion angle, maximum deformation followed this order: M Type < C Type < L Type. The L3 type necrotic area experienced the most significant deformation at 0, 60, and 110° angles (1.121, 1.7913, and 1.8239 mm respectively). (2) Under the same CJFH classification, maximum deformation values increased with hip flexion angle (0 < 60 < 110°), suggesting a higher risk of collapse at larger angles. (3) Von Mises stress results showed that the maximum stress was not located in the necrotic area but near the inner and outer edge of the femoral neck, indicating decreased stiffness and strength of the subchondral bone after osteonecrosis. Conclusion The study found that femoral head collapse risk was higher when the necrotic area was located in the lateral column under the same stress load and flexion angle. Mechanical properties of the necrotic area changed, resulting in decreased bone strength and stiffness. Large‐angle hip flexion is more likely to cause excessive deformation of the necrotic area; thus, ONFH patients should reduce or avoid large‐angle hip flexion during weight‐bearing training in rehabilitation activities. |
| first_indexed | 2024-03-11T19:58:27Z |
| format | Article |
| id | doaj.art-54728e819c774c79929d7a394927b5b7 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-11T19:58:27Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-54728e819c774c79929d7a394927b5b72023-10-04T14:23:12ZengWileyOrthopaedic Surgery1757-78531757-78612023-10-0115102689270010.1111/os.13865The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element StudyMing‐Tao Wen0Xue‐Zhen Liang1Di Luo2Jia‐Cheng Li3Bo‐Zhao Yan4Bo‐Wen Lu5Yan‐Bo Guo6Bo Xu7Gang Li8The First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaThe First Clinical Medical School Shandong University of Traditional Chinese Medicine Jinan ChinaObjective The alteration in the mechanical environment of the necrotic area is the primary cause of the collapse observed in osteonecrosis of the femoral head (ONFH). This study aims to evaluate the biomechanical implications of the China‐Japan Friendship Hospital (CJFH) classification system and hip flexion angles on the necrotic area in ONFH using finite element analysis (FEA). The goal is to provide valuable guidance for hip preservation treatments and serve as a reference for clinical diagnosis and therapeutic interventions. Methods Hip tomography CT scan data from a healthy volunteer was used to create a 3D model of the left hip. The model was preprocessed and imported into Solidworks 2018, based on the CJFH classification. Material parameters and boundary conditions were applied to each fractal model in ANSYS 21.0. Von Mises stresses were calculated, and maximum deformation values were obtained to evaluate the biomechanical effects of the load on the necrotic area and post‐necrotic femur, as well as assess each fractal model's collapse risk. Results (1) At the same hip flexion angle, maximum deformation followed this order: M Type < C Type < L Type. The L3 type necrotic area experienced the most significant deformation at 0, 60, and 110° angles (1.121, 1.7913, and 1.8239 mm respectively). (2) Under the same CJFH classification, maximum deformation values increased with hip flexion angle (0 < 60 < 110°), suggesting a higher risk of collapse at larger angles. (3) Von Mises stress results showed that the maximum stress was not located in the necrotic area but near the inner and outer edge of the femoral neck, indicating decreased stiffness and strength of the subchondral bone after osteonecrosis. Conclusion The study found that femoral head collapse risk was higher when the necrotic area was located in the lateral column under the same stress load and flexion angle. Mechanical properties of the necrotic area changed, resulting in decreased bone strength and stiffness. Large‐angle hip flexion is more likely to cause excessive deformation of the necrotic area; thus, ONFH patients should reduce or avoid large‐angle hip flexion during weight‐bearing training in rehabilitation activities.https://doi.org/10.1111/os.13865BiomechanicsChina‐Japan friendship hospital classificationCollapseFinite element analysisHip flexion angleOsteonecrosis of femoral head |
| spellingShingle | Ming‐Tao Wen Xue‐Zhen Liang Di Luo Jia‐Cheng Li Bo‐Zhao Yan Bo‐Wen Lu Yan‐Bo Guo Bo Xu Gang Li The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study Orthopaedic Surgery Biomechanics China‐Japan friendship hospital classification Collapse Finite element analysis Hip flexion angle Osteonecrosis of femoral head |
| title | The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study |
| title_full | The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study |
| title_fullStr | The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study |
| title_full_unstemmed | The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study |
| title_short | The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China‐Japan Friendship Hospital Classification ‐ A Finite Element Study |
| title_sort | effect of the hip flexion angle in osteonecrosis of the femoral head based on china japan friendship hospital classification a finite element study |
| topic | Biomechanics China‐Japan friendship hospital classification Collapse Finite element analysis Hip flexion angle Osteonecrosis of femoral head |
| url | https://doi.org/10.1111/os.13865 |
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