A non-linear finite element analysis of some early collapse processes in femoral head osteonecrosis.

Some aspects of the early collapse biomechanics of the segmentally necrotic adult human femoral head were studied, using a small-deformation plane strain, elasto-plastic finite element model. The computational procedure used was based upon the initial stress technique, and permitted study of stress and strain fields and of the progression of failure regions as a function of incrementally applied joint loads. The results consistently demonstrated both subchondral and deep cancellous failure patterns similar to those seen clinically. There was a clear distinction, however, between these two failure regimes, dependent primarily upon the relative strength deficits input for the subchondral versus the deep cancellous regions. Usually, the failure zone was appreciable only at significantly supra-physiological loads, reflecting the likely importance of fatigue events in the clinical collapse process. Although subchondral failure was always limited to the entire base region of the infarction wedge, the zones of deep failure varied considerably with changes in lesion geometry, usually being concentrated within the infarct near the underlying necrotic/viable interface.