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      Fatigue life evaluation of different hip implant designs using finite element analysis

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          Abstract

          Fatigue failure is one of the causes of the failure of hip implants. The main objective of this work is to carry out fatigue failure analysis on different hip profiles and compare the outcomes for various combinations of materials. Three profiles each for circular, oval, elliptical, and trapezoidal stems are utilized for this study with four different material combinations consisting of materials like Ti-6Al-4V, CoCr Alloy and UHMWPE. CATIA V-6 is used for the modelling of these implants and the fatigue analysis using Goodman's mean stress theory is simulated using ANSYS 2022 R1. ISO 7206-4 and ASTM F2996-13 standards are used to define the boundary conditions. A total of 48 combinations were studied across four different shapes, three different profiles and four different material combinations to deduce the best possible combination for a hip implant for static and fatigue loading. Comparison of the implants is based on the factors like equivalent von Mises stress, displacement, equivalent elastic strain, fatigue life, safety factor and equivalent alternating stress. Profile 2 of the trapezoidal-shaped hip implant with a Ti-6Al-4V stem exhibited superior results both under static and fatigue loading conditions. Compared to displacements obtained for profiles one and three, profile 2 trapezoidal stem with Ti-6Al-4V and other parts as CoCr Alloy has about 72% lower displacement. Based on the findings, profile 2 with a trapezoidal stem made of Ti-6Al-4V and an acetabular cup made of CoCr shows the enhanced results over the other combinations considered.

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          Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.

          Over the past decade, there has been an increase in the number of revision total hip and knee arthroplasties performed in the United States. The purpose of this study was to formulate projections for the number of primary and revision total hip and knee arthroplasties that will be performed in the United States through 2030. The Nationwide Inpatient Sample (1990 to 2003) was used in conjunction with United States Census Bureau data to quantify primary and revision arthroplasty rates as a function of age, gender, race and/or ethnicity, and census region. Projections were performed with use of Poisson regression on historical procedure rates in combination with population projections from 2005 to 2030. By 2030, the demand for primary total hip arthroplasties is estimated to grow by 174% to 572,000. The demand for primary total knee arthroplasties is projected to grow by 673% to 3.48 million procedures. The demand for hip revision procedures is projected to double by the year 2026, while the demand for knee revisions is expected to double by 2015. Although hip revisions are currently more frequently performed than knee revisions, the demand for knee revisions is expected to surpass the demand for hip revisions after 2007. Overall, total hip and total knee revisions are projected to grow by 137% and 601%, respectively, between 2005 and 2030. These large projected increases in demand for total hip and knee arthroplasties provide a quantitative basis for future policy decisions related to the numbers of orthopaedic surgeons needed to perform these procedures and the deployment of appropriate resources to serve this need.
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            How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up

            Summary Background Total hip replacement is a common and highly effective operation. All hip replacements would eventually fail if in situ long enough and it is important that patients understand when this might happen. We aimed to answer the question: how long does a hip replacement last? Methods We did a systematic review and meta-analysis with a search of MEDLINE and Embase from the start of records to Sept 12, 2017. We included articles reporting 15-year survival of primary, conventional total hip replacement constructs in patients with osteoarthritis. We extracted survival and implant data and used all-cause construct survival as the primary outcome. We also reviewed reports of national joint replacement registries, and extracted data for a separate analysis. In the meta-analyses, we weighted each series and calculated a pooled survival estimate for each source of data. This study was registered with PROSPERO (CRD42018085642). Findings We identified 140 eligible articles reporting 150 series, and included 44 of these series (13 212 total hip placements). National joint replacement registries from Australia and Finland provided data for 92 series (215 676 total hip replacements). The 25-year pooled survival of hip replacements from case series was 77·6% (95% CI 76·0–79·2) and from joint replacement registries was 57·9% (95% CI 57·1–58·7). Interpretation Assuming that estimates from national registries are less likely to be biased, patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients. Funding National Institute for Health Research, National Joint Registry for England, Wales, Northern Ireland and Isle of Man, and The Royal College of Surgeons of England.
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              Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030.

              Previous projections of total joint replacement (TJR) volume have not quantified demand for TJR surgery in young patients (< 65 years old). We developed projections for demand of TJR for the young patient population in the United States. The Nationwide Inpatient Sample was used to identify primary and revision TJRs between 1993 and 2006, as a function of age, gender, race, and census region. Surgery prevalence was modeled using Poisson regression, allowing for different rates for each population subgroup over time. If the historical growth trajectory of joint replacement surgeries continues, demand for primary THA and TKA among patients less than 65 years old was projected to exceed 50% of THA and TKA patients of all ages by 2011 and 2016, respectively. Patients less than 65 years old were projected to exceed 50% of the revision TKA patient population by 2011. This study underscores the major contribution that young patients may play in the future demand for primary and revision TJR surgery. Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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                Author and article information

                Journal
                Journal of Applied Engineering Science
                J Appl Eng Science
                Centre for Evaluation in Education and Science (CEON/CEES)
                1451-4117
                1821-3197
                2023
                2023
                : 21
                : 3
                : 896-907
                Article
                10.5937/jaes0-44094
                cb618c1e-aee0-494a-91d5-e456a08a0bac
                © 2023

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