Due to polymeric wear debris causing osteolysis from polymer, metal ions causing metallosis from metal, and brittle characteristic causing fracture failure from ceramic in the application on bearing of total hip prosthesis requires the availability of new material options as a solution to these problems. Polycrystalline diamond (PCD) has the potential to become the selected material for hard-on-hard bearing in view of its advantages in terms of mechanical properties and biocompatibility. The present study contributes to confirming the potential of PCD to replace metals and ceramics for hard-on-hard bearing through von Mises stress investigations. A computational simulation using a 2D axisymmetric finite element model of hard-on-hard bearing under gait loading has been performed. The percentage of maximum von Mises stress to respective yield strength from PCD-on-PCD is the lowest at 2.47%, with CoCrMo (cobalt chromium molybdenum)-on-CoCrMo at 10.79%, and Al2O3 (aluminium oxide)-on-Al2O3 at 13.49%. This confirms that the use of PCD as a hard-on-hard bearing material is the safest option compared to the investigated metal and ceramic hard-on-hard bearings from the mechanical perspective.

/pdf/polycrystalline-diamond-as-a-potential-material-for-the-hard-2bn8ipyu.pdf

Polycrystalline Diamond as a Potential Material for the Hard-on-Hard Bearing of Total Hip Prosthesis: Von Mises Stress Analysis

http://www.cell.com/article/S2405844022033382/pdf

Adopted walking condition for computational simulation approach on bearing of hip joint prosthesis: review over the past 30 years

Background:
Footprints from force sensitive resistor (FSR) type pressure platforms have been shown to differ from ink prints, leading to a relative distortion of the arch index (AI). 
Objective:
To compare the accuracy of the AI derived from a capacitance pressure platform relative to ink footprints. 
Method:
Area measurements (heel, midfoot, forefoot, hallux and lesser toes) were acquired simultaneously from ink footprints and a pressure platform. Difference between paired values revealed relative measurement error. 
Results:
The platform overestimated heel area (2.2%), but underestimated midfoot area (10.2%), and lesser toe area (17.7 %). The mean AIs were 0.206 (platform) and 0.230 (ink prints). 
Conclusions:
The pressure platform closely estimated contact areas for the heel and forefoot. Midfoot areas were underestimated sufficiently to bias the AI towards lower values. Therefore, the AI derived from a capacitance pressure platform is not the same as that from an ink footprint, and the two should not be used interchangeably. Feet classified according to AI from a pressure platform may be categorised differently than they would by using ink footprints. Pressure platform data cannot be used to determine AI with confidence until relative measurement error for isolated foot regions has been determined, or appropriate normative values established.

Arch indexes from ink footprints and pressure platforms are different

Abstract Hip joint prostheses are used to replace hip joint function in the human body. The latest dual-mobility hip joint prosthesis has an additional component of an outer liner that acts as a cover for the liner component. Research on the contact pressure generated on the latest model of a dual-mobility hip joint prosthesis under a gait cycle has never been done before. The model is made of ultrahigh molecular weight polyethylene (UHMWPE) on the inner liner and 316L stainless steel (SS 316L) on the outer liner and acetabular cup. Simulation modeling using the finite element method is considered static loading with an implicit solver for studying the geometric parameter design of dual-mobility hip joint prostheses. In this study, simulation modeling was carried out by applying varying inclination angles of 30°, 40°, 45°, 50°, 60°, and 70° to the acetabular cup component. Three-dimensional loads were placed on femoral head reference points with variations of femoral head diameter used at 22 mm, 28 mm, and 32 mm. The results in the inner surface of the inner liner, the outer surface of the outer liner, and the inner surface of the acetabular cup showed that the variations in inclination angle do not have a major effect on the maximum contact pressure value on the liner component, where the acetabular cup with an inclination angle of 45° can reduce contact pressure more than the other studied inclination angle variations. In addition, it was found that the 22 mm diameter of the femoral head increases the contact pressure. The use of a larger diameter femoral head with an acetabular cup configuration at a 45° inclination can minimize the risk of implant failure due to wear. 

Analysis of contact pressure in a 3D model of dual-mobility hip joint prosthesis under a gait cycle

Total hip arthroplasty (THA) is most likely one of the most successful surgical procedures in medicine. It is estimated that three in four patients live beyond the first post-operative year, so appropriate surgery is needed to alleviate an otherwise long-standing suboptimal functional level. However, research has shown that during a complete THA procedure, a solid hip implant inserted in the femur can damage the main arterial supply of the cortex and damage the medullary space, leading to cortical bone resorption. Therefore, this study aimed to design a porous hip implant with a focus on providing more space for better osteointegration, improving the medullary revascularisation and blood circulation of patients. Based on a review of the literature, a lightweight implant design was developed by applying topology optimisation and changing the materials of the implant. Gyroid and Voronoi lattice structures and a solid hip implant (as a control) were designed. In total, three designs of hip implants were constructed by using SolidWorks and nTopology software version 2.31. Point loads were applied at the x, y and z-axis to imitate the stance phase condition. The forces represented were x = 320 N, y = −170 N, and z = −2850 N. The materials that were used in this study were titanium alloys. All of the designs were then simulated by using Marc Mentat software version 2020 (MSC Software Corporation, Munich, Germany) via a finite element method. Analysis of the study on topology optimisation demonstrated that the Voronoi lattice structure yielded the lowest von Mises stress and displacement values, at 313.96 MPa and 1.50 mm, respectively, with titanium alloys as the materials. The results also indicate that porous hip implants have the potential to be implemented for hip implant replacement, whereby the mechanical integrity is still preserved. This result will not only help orthopaedic surgeons to justify the design choices, but could also provide new insights for future studies in biomechanics.

/pdf/biomechanical-effects-of-the-porous-structure-of-gyroid-and-l5spk8jh.pdf

Biomechanical Effects of the Porous Structure of Gyroid and Voronoi Hip Implants: A Finite Element Analysis Using an Experimentally Validated Model

The choice of ceramic-on-ceramic coupling in total hip prosthesis has advantages over couplings with other combinations of materials that use polyethylene and metal materials in terms of high hardness, scratch resistance, low wear rate, and increased lubrication performance. To reduce the risk of primary postoperative failure, the selection of ceramic materials for ceramic-on-ceramic coupling is a strategic step that needs to be taken. The current study aims to analyze ceramic-on-ceramic coupling with commonly used ceramic materials, namely zirconium dioxide (ZrO2), silicon nitride (Si3N4), and aluminium oxide (Al2O3), according to Tressa failure criterion for the investigation of the stress distribution. A two-dimensional axisymmetric finite element-based computational model has been used to evaluate the Tresca stress on ceramic-on-ceramic coupling under gait cycle. The results show that the use of ZrO2-on-ZrO2 couplings can reduce Tresca stress by about 17.34% and 27.23% for Si3N4-on-Si3N4 and Al2O3-on-Al2O3 couplings, respectively.

/pdf/minimizing-risk-of-failure-from-ceramic-on-ceramic-total-hip-1gkbzw0f.pdf

Minimizing Risk of Failure from Ceramic-on-Ceramic Total Hip Prosthesis by Selecting Ceramic Materials Based on Tresca Stress

The objective of this study is to investigate the effect of contouring the shoe insole on calcaneal pressure and heel pain in calcaneal spur patients. Calcaneal pressure was measured using three force sensors from 13 patients including three males and 10 females. These patients have plantar heel pain due to calcaneal spurs, and we examined five customized contour insole foot areas (0–100%). Sensors were attached at the central heel (CH), lateral heel (LH) and medial heel (MH) of the foot. The pain was measured using an algometer and evaluated by the pain minimum compressive pressure (PMCP). In this study, it was observed that the calcaneal pressure decreased with increasing insole foot area. In addition, increasing the insole foot area from 25% to 50% can reduce the calcaneal pressure approximately 17.4% at the LH and 30.9% at the MH, which are smaller than the PMCP, while at the MH, pressure reduced 6.9%, which is greater than the PMCP. Therefore, to reduce pain, one can use 50% insole foot area, even though at MH it is still 19.3% greater than the PMCP. Excellent pain relief was observed when using 100% insole foot area, as the pressures in those three areas are lower than the PMCPs, but it is not recommended because it requires large production costs.

https://www.mdpi.com/2076-3417/9/3/495/pdf

Effect of In-Shoe Foot Orthosis Contours on Heel Pain Due to Calcaneal Spurs

The analysis of normal and pathological variation in human foot morphology is central to several biomedical disciplines, including orthopedics, orthotic design, sports sciences, and physical anthropology, and it is also important for efficient footwear design. A classic and frequently used approach to study foot morphology is analysis of the footprint shape and footprint depth. Footprints are relatively easy to produce and to measure, and they can be preserved naturally in different soils. In this study, we need to correlate footprint depth with corresponding foot pressure of individual using 3D scanner. Several approaches are used for modeling and estimating footprint depths and foot pressures. The deepest footprint point is calculated from z max coordinate-z min coordinate and the average of foot pressure is calculated from GRF divided to foot area contact and identical with the average of footprint depth. Evaluation of footprint depth was found from importing 3D scanner file (dxf) in AutoCAD, the z-coordinates than sorted from the highest to the lowest value using Microsoft Excel to make footprinting depth in difference color. This research is only qualitatif study because doesn’t use foot pressure device as comparator, and resulting the maximum pressure on calceneus is 3.02 N/cm2, lateral arch is 3.66 N/cm2, and metatarsal and hallux is 3.68 N/cm2.

/pdf/estimation-of-foot-pressure-from-human-footprint-depths-3v7qdrjj4w.pdf

Estimation of foot pressure from human footprint depths using 3D scanner

[Purpose] To investigate the effect of heel height on the distribution of plantar foot force and heel pain in patients with a heel spur. [Subjects and Methods] Plantar force was measured using 8 force sensors in 16 patients (3 men, 13 women), with symptomatic heel spur for 4 heel heights (0-4 cm). Sensors were located at the hallux (T1); medial to lateral metatarsals (M1 through M3), mid-foot (MF); and at the central, lateral, and medial heel (CH, LH, and MH). Pain was evaluated using the minimum compression force that caused pain and was measured using an algometer. [Results] Load bearing shifted from the heel (CH) to the mid-foot (MF) and hallux (T1) with increasing heel height. Raising the heel from 2 to 3 cm reduced the magnitude of load bearing, relative to the minimum compression force for pain, by 3.70% at the LH and 2.35% at the MH. Excellent clinical outcomes, defined by a 70-100% decrease in pain, were achieved in 10/16 participants with the use of a 2-cm and 3-cm heel height in men and women, respectively. [Conclusion] Increasing heel height effectively decreases the plantar force on the heel during weight-bearing activities.

/pdf/the-effectiveness-of-raising-the-heel-height-of-shoes-to-4lr08cxwnu.pdf

The effectiveness of raising the heel height of shoes to reduce heel pain in patients with calcaneal spurs

This research studies the relationship between footprint depths and load in the calcaneal area when human standing in an upright posture. Footprint depths are deformation in the calcaneal area obtained from the z-value extraction of the Boolean operation acquired from unloaded foot scanning using 3D scanner and loaded foot using foot plantar scanner. To compare peak loads estimated from footprint depth maximum, force sensing resistor (FSR) sensor is attached over the shoe insole with zero heel height in the calcaneal area. Twenty participants were selected from students of Mechanical Engineering Department Diponegoro University with the average the age and the body weight 19.5 years and 55.27 kg respectively. Results that were relatively accurate was found on the calcaneal loading estimation by footprint depth is presented by curve and data distribution which are in good agreement with the result of the measurement. A significant difference in estimating calcaneal loading is mainly caused by plantar foot ...

Dwi Basuki Wibowo

Papers

Minimizing Risk of Failure from Ceramic-on-Ceramic Total Hip Prosthesis by Selecting Ceramic Materials Based on Tresca Stress

Effect of In-Shoe Foot Orthosis Contours on Heel Pain Due to Calcaneal Spurs

Estimation of foot pressure from human footprint depths using 3D scanner

The effectiveness of raising the heel height of shoes to reduce heel pain in patients with calcaneal spurs

Estimation of calcaneal loading during standing from human footprint depths using 3D scanner