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Study On A Novel Hip Joint Replacement Surgical Technique

INTRODUCTION The hip joint is a ball and socket type joint that consists of the ball-shaped femoral head, two layers of articular cartilage, the acetabular ligament, and the acetabulum socket [1]. Its major function is to maintain body balance and support body weight in both static and dynamic postures, including walking, running, and etc. Osteoarthritis (OA) is one of the most common causes of THR. It stems from the softening and loss of articular cartilage, leading to the loss of congruity and subtle instability of hip joints. This loss of articular cartilage can eventually cause direct bone-to-bone contact between the femoral head and acetabulum, which results in bone spurs and pain, accompanied by joint disability and reductions in life quality. Total hip replacement (THR) involves surgical removal of the diseased ball and socket and replacing them with a ball and stem that is inserted into the femur bone and an artificial cup socket. THR works to help patients with severe OA restore their natural movement [2]. However, despite its extremely high successful rate with an average lifespan of approximately 15 years, current THR has certain drawbacks, including device failure caused by femoral stem fracture, acetabular cup wear, and bone density loss caused by stress shielding. Therefore, with the help of a surgeon from UC Davis, we are researching the possibility of developing a new surgical technique that restores the functionality of a degenerated hip joint. This surgical technique is specifically designed for patients with severe degenerated hip articular cartilage. It involves the surgical removal of the degenerated part of the femoral head and replacing it with the corresponding healthy femoral head portion from a donor. Mating surfaces of the both parts are surgically cut so they form a compatible fit, acting as a fixture mechanism. Ideally, this surgical technique works like a bone graft: after a certain period of bone regeneration, the two parts fuse together. As this surgical technique is still at its proposal state, the feasibility is unclear. Therefore, our study aims to use finite element analysis (FEA) to help investigate the feasibility of this surgical technique by looking at the stress states of the postoperative hip joint from different fixture designs under different mechanical loading states.