One of the main drawbacks of hemiarthroplasty is that it involves the articulation of a foreign material against the native cartilage, and hence the native cartilage experiences accelerated wear. It is hypothesized that lowering the stiffness of hemiarthroplasty implants will decrease contact pressure and increase contact area, thus decrease wear. Lowering the stiffness was done using finite element analysis to lower the stiffness of the implant materials, and then to change the internal structure of the implants to increase their compliance. Structural changes produced no noticeable or favourable results, whereas material produced improved results for stiffnesses below a Young’s modulus of 300 MPa. A cadaveric study was done to compare a high, mid, and ultra-low stiffness material to the native state. It was found that only the ultra- low stiffness material improved contact mechanics. Future hemiarthroplasty implant designs should focus on using materials with a Young’s modulus below the aforementioned threshold.
Keywords:
Hemiarthroplasty; compliant designs; material selection; contact mechanics; lower stiffness; contact pressure; contact area