Polyethylene wear after total hip arthroplasty may occur as a result of normal gait and as a result of subluxation and relocation with impact. Relocation of a subluxed hip may impart a moment to the cup creating sliding as well as compression at the cup liner interface. The purpose of the current study is to quantify, by a validated finite element model, the forces generated in a hip arthroplasty as a result of subluxation relocation and compare them to the forces generated during normal gait. The micromotion between the liner and acetabular shell was quantified by computing the sliding track and the deformation at several points of the interface. A finite element analysis of polyethylene liner stress and liner/cup micromotion in total hip arthroplasty was performed under two dynamic profiles. The first profile was a gait loading profile simulating the force vectors developed in the hip arthroplasty during normal gait. The second profile is generated during subluxation and subsequent relocation of the femoral head. The forces generated by subluxation relocation of a total hip arthroplasty can exceed those forces generated during normal gait. The induced micromotion at the cup polyethylene interface as a result of subluxation can exceed micromotion as a result of the normal gait cycle. This may play a significant role in the generation of backsided wear. Minimizing joint subluxation by restoring balance to the hip joint after arthroplasty should be explored as a strategy to minimize backsided wear.
Arthroplasty, Replacement, Hip Biomechanical Phenomena