2019/01/14 by Mahsan Bakhtiarinejad, Bakhtiarinejad, Mahsan, Farshid Alambeigi +9
Medicine · #Bone and Joint Diseases #FOS: Biological sciences #Orthopaedic implants and arthroplasty #Orthopedic Infections and Treatments #Tissues and Organs (q-bio.TO)
paper · pdf · doi:10.48550/arxiv.1901.07461
openalex publication_date 2019/01/14 · openalex created_date 2022/07/30 · openalex updated_date 2026/07/28
Osteonecrosis occurs due to the loss of blood supply to the bone, leading to\nspontaneous death of the trabecular bone. Delayed treatment of the involved\npatients results in collapse of the femoral head, which leads to a need for\ntotal hip arthroplasty surgery. Core decompression, as the most popular\ntechnique for treatment of the osteonecrosis, includes removal of the lesion\narea by drilling a straight tunnel to the lesion, debriding the dead bone and\nreplacing it with bone substitutes. However, there are two drawbacks for this\ntreatment method. First, due to the rigidity of the instruments currently used\nduring core decompression, lesions cannot be completely removed and/or\nexcessive healthy bone may also be removed with the lesion. Second, the use of\nbone substitutes, despite its biocompatibility and osteoconductivity, may not\nprovide sufficient mechanical strength and support for the bone. To address\nthese shortcomings, a novel robot-assisted curved core decompression (CCD)\ntechnique is introduced to provide surgeons with direct access to the lesions\ncausing minimal damage to the healthy bone. In this study, with the aid of\nfinite element (FE) simulations, we investigate biomechanical performance of\ncore decompression using the curved drilling technique in the presence of\nnormal gait loading. In this regard, we compare the result of the CCD using\nbone substitutes and flexible implants with other conventional core\ndecompression techniques. The study finding shows that the maximum principal\nstress occurring at the superior domain of the neck is smaller in the CCD\ntechniques (i.e. 52.847 MPa) compared to the other core decompression methods.\n