The effect of cup inclination and wear on the contact mechanics and cement fixation for ultra high molecular weight polyethylene total hip replacements

The present study aimed to investigate individual and combined influences of the cup inclination and wear on the contact mechanics and fixation of a Charnley hip replacement using finite element method. The effects of cup inclination and penetration on the contact mechanics of articulating bearings as well as the stress within the cement and at the bone-cement interface were examined. The maximum contact pressure and the von Mises stress on the cup were reduced by ~30% and ~20% respectively when even a small penetration occurred. However, no large differences were found between different cup penetration depths with regards to either the contact pressure or the von Mises stress. The von Mises stress at the bone-cement interface was predicted almost unaltered with an increased cup inclination angle to 55° for a cup penetration to 4mm. These predictions suggest that the contact mechanics and the cement stress are insensitive to the cup inclination and wear under these normal conditions investigated, therefore explaining the robustness of the Charnley hip implant. An increase in the cup inclination angle to 65°, coupled with a maximum penetration of 4mm, resulted in a large increase in the maximum von Mises stress at the bone-cement interface.