Effects of sclerotic changes on stress concentration in early-stage osteonecrosis: A patient-specific, 3D finite element analysis

摘要: Stress distribution remains unclear in early-stage osteonecrosis of the femoral head (ONFH). To clarify this issue, we generated patient-specific finite element models (FEMs) from 51 patients with ONFH. Patients' hips were classified into three groups: ONFH without a sclerotic boundary (Stage 1, n = 6), 2, 10), and both <2 mm collapse 3, 35). Four used as controls. each FEM was compared magnetic resonance imaging (MRI) computed tomography (CT) results. Fifteen wholly resected heads Stage 3 assessed by micro-CT. Furthermore, histologically examined 2 that subsequently developed subchondral fractures after analyses. In all FEMs control 1 hip, stress equally distributed on surface. However, Stages hips, concentrated at lateral surface, corresponding to low-intensity band T1-weighted MRI images changes CT. On micro-CT, consistently began changes, which bone volume fraction increased. Histology showed breakage plates junction between necrotic reparative zones. ONFH, caused concentration, can trigger boundary. Clinical Significance: Our results will pathogenic mechanism © 2018 Orthopaedic Research Society. Published Wiley Periodicals, Inc. J Orthop Res 36:3169-3177, 2018.