Sensitivity-Analysis in biomechanical modelling and its relevance for total hip arthroplasty An application oriented analysis

C. Ebeling, L. Raiser

Abstract: The replacement of the hip joint by a prosthetic implant is one of the most common orthopaedic surgical procedures in Germany. The long-term success of a total hip arthroplasty is dependent on the careful analysis of the loads due to joint and muscle forces in the surgery planning as well as the operative care. Yet, patient-specific information of forces occurring in vivo is not available to the surgeon in clinical routine today. Biomechanical modelling aims to fill this gap. One field of biomechanical modelling is the development of methods and procedures for the accurate analysis and realistic simulation of endoprosthetic supplies. The aim of this paper is to demonstrate the possibilities of biomechanical modelling in total hip arthroplasty using two examples: sensitivity analysis and pre-/ postoperative comparison of intervention outcome. The results of the sensitivity analysis indicate that the modelling can provide the optimal position of reconstruction of the hip rotational center leading to a significant decrease in the forces acting on the hip joint. By comparing the pre- to the postoperative state, it can be analyzed whether there is a decrease or increase of load after surgery or whether the conditions are considered to be approximately equal to the preoperative situation. With improving technology, biomechanical modelling will be able to significantly increase long-term function by reducing abrasion and optimizing muscular function. Therefore, the introduction of validated musculoskeletal analysis in the context of standardized preoperative planning and intraoperative navigation-based implementation, into routine use should be considered. Thus, the validated analysis of musculoskeletal loads can lead to the optimization of endoprosthetic care through its integration into the clinical workflow, while providing feedback for basic research at the same time.

Series on Biomechanics, Vol.33, No. 3(2019), 40-48

Keywords: Pauwel model; Sensitivity analysis; total hip arthroplasty

Date published: 2019-10-22