Abstract
Background
Subchondral insufficiency fracture of the femoral head generally occurs without evidence
of trauma or with a history of minor trauma. Insufficient bone quality is considered
one cause; however, the detailed mechanism of fracture development at the subchondral
area (SA) is not understood. The aim of this study was to clarify the directions of
force that cause subchondral fracture using finite element model analysis.
Methods
Two types of finite element models were generated from the CT data of femurs obtained
from three individuals without osteoporosis (normal models) and another three with
osteoporosis (osteoporosis models). Three directions of force, including compressive,
shearing, and torsional, were applied to the femoral head. The distribution of von
Mises stress (Mises stress) was evaluated at the SA, principal compressive trabeculae
(PC), and principal tensile trabeculae.
Results
Under compressive force, the mean Mises stress value was greatest at the PC in both
the normal and osteoporosis models. Under shearing force, the mean Mises stress value
tended to be greatest at the SA in the normal model and at the PC in the osteoporosis
model. Under torsional force, the mean Mises stress value was greatest at the SA in
both types of models.
Conclusions
The torsional force showed the greatest Mises stress at the SA in both the normal
and osteoporosis models, suggesting the importance of torsion as a possible force
responsible for subchondral insufficiency fracture development.
Keywords
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 8,
2023
Received in revised form:
February 6,
2023
Received:
December 21,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
