Injecting hyaluronan in the thoracolumbar fascia: A model study.

Hyaluronan (HA) has been recently identified as a key component of the densification of thoracolumbar fascia (TLF), a potential contributor to non-specific lower back pain (LBP) currently treated with manual therapy and systemic or local delivery of anti-inflammatory drugs. The aim of this study was to establish a novel animal model suitable for studying ultrasound-guided intrafascial injection prepared from HA with low and high Mw. Effects of these preparations on the profibrotic switch and mechanical properties of TLF were measured by qPCR and rheology, respectively, while their lubricating properties were evaluated by tribology. Rabbit proved to be a suitable model of TLF physiology due to its manageable size enabling both TLF extraction and in situ intrafascial injection. Surprisingly, the tribology showed that low Mw HA was a better lubricant than the high Mw HA. It was also better suited for intrafascial injection due to its lower injection force and ability to freely spread between TLF layers. No profibrotic effects of either HA preparation in the TLF were observed. The intrafascial application of HA with lower MW into the TLF appears to be a promising way how to increase the gliding of the fascial layers and target the myofascial LBP.

A composite device for viscosupplementation treatment resistant to degradation by reactive oxygen species and hyaluronidase.

Osteoarthritis (OA) is one of the most common musculoskeletal disorders in the world. OA is often associated with the loss of viscoelastic and tribological properties of synovial fluid (SF) due to degradation of hyaluronic acid (HA) by reactive oxygen species (ROS) and hyaluronidases. Viscosupplementation is one of the ways how to effectively restore SF functions. However, current viscosupplementation products provide only temporal therapeutic effect because of short biological half-life. In this article we describe a novel device for viscosupplementation (NV) based on the cross-linked tyramine derivative of HA, chondroitin sulfate (CS), and high molecular weight HA by online determination of viscoelastic properties loss during degradation by ROS and hyaluronidase. Rheological and tribological properties of developed viscosupplement were compared with HA solutions with different molecular weights in the range 500-2000 kDa, which are currently commonly used as medical devices for viscosupplementation treatment. Moreover, based on clinical practice and scientific literature all samples were also diluted by model OA SF in the ratio 1:1 (vol/vol) to better predict final properties after injection to the joint. The observed results confirmed that NV exhibits appropriate rheological properties (viscosity, elastic, and viscous moduli) comparable with healthy SF and maintain them during degradation for a significantly longer time than HA solutions with molecular weight in the range 500-2000 kDa and cross-linked material without CS.

Tribological behaviour of 3D printed materials for small joint implants: A pilot study.

Additive manufacturing is a progressive method in endoprosthetics enabling customisation of implants. However, the challenge is to design articulating surfaces that are wear resistant in a long term. To tackle this challenge, it is necessary to understand the interaction between the surfaces and the lubricant synovial fluid as well as the mechanism of lubrication film formation. In this study we observed three synovial fluid constituents (albumin, γ-globulin a hyaluronic acid) in the contact area simultaneously with the coefficient of friction (CoF). Two metal alloys, CoCrMo and Ti6Al4V covered by DLC, were selected for the experiments as they are both suitable for the additive technology and commonly used in implants manufacturing. The tests were running on a custom-made pin-on-plate tribometer equipped for optical fluorescence measurements. The test apparatus allowed reciprocating motion and observation of the contact area. Our results showed differences in the pace of the CoF increase between the alloys and differences between the samples manufactured by the conventional and the additive manufacturing method. Both the conventionally and additively manufactured CrCrMo samples showed a stable CoF values from the beginning of the experiments: 0.66 (SD 0.02) for the conventional manufacturing CrCrMo samples and 0.53 (SD 0.01) for the additive manufacturing CrCrMo samples. The Ti6Al4V/DLC samples showed a stable CoF values similar to those of the CoCrMo samples not until the 240 s of experiment. These results are related to the protein formation in the contact areas as suggested by a similar increasing trend of the individual synovial fluid constituents in the contact. Increasing protein amounts in the contact led to CoF increase. There were also differences in the ratios of the individual constituents, where both the CoCrMo and the Ti6Al4V/ DLC samples manufactured additionally showed lower concentrations of γ-globulin and hyaluronic acid. These pilot results, on the one hand, support the potential of the additive manufacturing in the implantology and, on the other hand, demonstrate the application of a method suitable for the analysis of the lubricant behaviour in the contact. The method is limited in using the intensity of the emitted light to observe the behaviour of the lubricant film. Future development of the method will require a direct quantification of film thickness.

Insight into the Lubrication and Adhesion Properties of Hyaluronan for Ocular Drug Delivery.

Hyaluronan (HA) is widely used for eye drops as lubricant to counteract dry eye disease. High and low molecular weight HA are currently used in ophthalmology. However, a large portion of the current literature on friction and lubrication addresses articular (joint) cartilage. Therefore, eye drops compositions based on HA and its derivatized forms are extensively characterized providing data on the tribological and mucoadhesive properties. The physiochemical properties are investigated in buffers used commonly in eye drops formulations. The tribological investigation reveals that amphiphilic HA-C12 decreases the friction coefficient. At the same time, the combination of trehalose/HA or HAC12 enhances up to eighty-fold the mucoadhesiveness. Thus, it is predicted a prolonged residence time on the surface of the eye. The incorporation of trehalose enhances the protection of human keratinocytes (HaCaT) cells, as demonstrated in an in-vitro cell-desiccation model. The presence of trehalose increases the friction coefficient. Medium molecular weight HA shows significantly lower friction coefficient than high molecular weight HA. This research represents a first, wide array of features of diverse HA forms for eye drops contributing to increase the knowledge of these preparations. The results here presented also provide valuable information for the design of highly performing HA-formulations addressing specific needs before preclinic.

Analysis of Chemisorbed Tribo-Film for Ceramic-on-Ceramic Hip Joint Prostheses by Raman Spectroscopy.

To understand the possible lubricant mechanism in ceramic-on-ceramic hip joint prostheses, biochemical reactions of the synovial fluid and the corresponding frictional coefficients were studied. The experiments were performed in a hip joint simulator using the ball-on-cup configuration with balls and cups made from two types of ceramics, BIOLOX®forte and BIOLOX®delta. Different lubricants, namely albumin, γ-globulin, hyaluronic acid and three model synovial fluids, were studied in the experiments and Raman spectroscopy was used to analyze the biochemical responses of these lubricants at the interface. BIOLOX®delta surface was found less reactive to proteins and model fluid lubricants. In contrast, BIOLOX®forte ball surface has shown chemisorption with both proteins, hyaluronic acid and model fluids imitating total joint replacement and osteoarthritic joint. There was no direct correlation between the measured frictional coefficient and the observed chemical reactions. In summary, the study reveals chemistry of lubricant film formation on ceramic hip implant surfaces with various model synovial fluids and their components.

On the Dependence of Rheology of Hyaluronic Acid Solutions and Frictional Behavior of Articular Cartilage.

Hyaluronic acid (HA) injections represent one of the most common methods for the treatment of osteoarthritis. However, the clinical results of this method are unambiguous mainly because the mechanism of action has not been clearly clarified yet. Viscosupplementation consists, inter alia, of the improvement of synovial fluid rheological properties by injected solution. The present paper deals with the effect of HA molecular weight on the rheological properties of its solutions and also on friction in the articular cartilage model. Viscosity and viscoelastic properties of HA solutions were analyzed with a rotational rheometer in a cone-plate and plate-plate configuration. In total, four HA solutions with molecular weights between 77 kDa and 2010 kDa were tested. The frictional measurements were realized on a commercial tribometer Bruker UMT TriboLab, while the coefficient of friction (CoF) dependency on time was measured. The contact couple consisted of the articular cartilage pin and the plate made from optical glass. The contact was fully flooded with tested HA solutions. Results showed a strong dependency between HA molecular weight and its rheological properties. However, no clear dependence between HA molecular weight and CoF was revealed from the frictional measurements. This study presents new insight into the dependence between rheological and frictional behavior of the articular cartilage, while such an extensive investigation has not been presented before.

Biotribology of Synovial Cartilage: A New Method for Visualization of Lubricating Film and Simultaneous Measurement of the Friction Coefficient.

A healthy natural synovial joint is very important for painless active movement of the natural musculoskeletal system. The right functioning of natural synovial joints ensures well lubricated contact surfaces with a very low friction coefficient and wear of cartilage tissue. The present paper deals with a new method for visualization of lubricating film with simultaneous measurements of the friction coefficient. This can contribute to better understanding of lubricating film formation in a natural synovial joint. A newly developed device, a reciprocating tribometer, is used to allow for simultaneous measurement of friction forces with contact visualization by fluorescence microscopy. The software allowing for snaps processing and subsequent evaluation of fluorescence records is developed. The evaluation software and the follow-up evaluation procedure are also described. The experiments with cartilage samples and model synovial fluid are carried out, and the new software is applied to provide their evaluation. The primary results explaining a connection between lubrication and friction are presented. The results show a more significant impact of albumin proteins on the lubrication process, whereas its clusters create a more stable lubrication layer. A decreasing trend of protein cluster count, which corresponds to a decrease in the thickness of the lubrication film, is found in all experiments. The results highlight a deeper connection between the cartilage friction and the lubrication film formation, which allows for better understanding of the cartilage lubrication mechanism.

The Effect of Synovial Fluid Composition, Speed and Load on Frictional Behaviour of Articular Cartilage.

Articular cartilage ensures smooth motion of natural synovial joints operating at very low friction. However, the number of patients suffering from joint diseases, usually associated with cartilage degradation, continuously increases. Therefore, an understanding of cartilage tribological behaviour is of great interest in order to minimize its degradation, preserving the reliable function of the joints. The aim of the present study is to provide a comprehensive comparison of frictional behaviour of articular cartilage, focusing on the effect of synovial fluid composition (i), speed (ii), and load (iii). The experiments were realized using a pin-on-plate tribometer with reciprocating motion. The articular cartilage pin was loaded against smooth glass plate while the tests consisted of loading and unloading phases in order to enable cartilage rehydration. Various model fluids containing albumin, γ-globulin, hyaluronic acid, and phospholipids were prepared in two different concentrations simulating physiologic and osteoarthritic synovial fluid. Two different speeds, 5 mm/s and 10 mm/s were applied, and the tests were carried out under 5 N and 10 N. It was found that protein-based solutions exhibit almost no difference in friction coefficient, independently of the concentration of the constituents. However, the behaviour is considerably changed when adding hyaluronic acid and phospholipids. Especially when interacting with γ-globulin, friction coefficient decreased substantially. In general, an important role of the interaction of fluid constituents was observed. On the other hand, a limited effect of speed was detected for most of the model fluids. Finally, it was shown that elevated load leads to lower friction, which corresponds well with previous observations. Further study should concentrate on specific explored phenomena focusing on the detailed statistical evaluation.

UHMWPE acetabular cup creep deformation during the run-in phase of THA's life cycle.

Ultra-high molecular polyethylene (UHMWPE) is one of the most used materials of the acetabular liners in total tip arthroplasty (THA). Polyethylene has good tribological properties and biocompatibility. However, the lifetime of polyethylene implants is limited by wear related complications. Polyethylene material released into the periprosthetic environment induces osteolysis that can be followed by implant loosening. Wear of cup is influenced mainly by orientation of the cup in pelvis, by initial geometry before the material degradation and by tribological parameters. Aim of this study is to focus on the run-in-phase of the liner which is predictive for future life cycles of liner. Creep deformations of liners for 30°, 45°, 60° inclination angles surgically recommended for the positioning in pelvis were analyzed by the optical scanning method. Load tests were performed for 50,000 cycles. Creep deformations and surface changes were analyzed at each 10,000 cycles. The results showed that liners with 60° inclination angle had higher creep deformations. Penetration of femoral head was 0.04-0.05 mm and occupied bearing area was around 77%. The smallest creep was measured for the 45° angle. However, deformation in the superior quadrant of acetabular rim, which is vulnerable for potential fracture of a liner, was identified in this case. Topography of the surface bearing was also observed during the run-in-phase. The surface was smoothened and showed multidirectional scratches caused by the influence of third body particles. This phase was followed by early delamination. Flakes sized approximately 5-20 µm were observed on the UHMWPE surface. This is similar to the'flake' shape wear debris extracted in vivo. Detailed analysis of run-in phase of loading of modern polyethylene implants can help to distinguish between their creep deformation and true degradation. The latter contributes strongly to the development of wear related complications associated with THAs limiting substantially their time in service.

The Effect of Kinematic Conditions and Synovial Fluid Composition on the Frictional Behaviour of Materials for Artificial Joints.

The paper introduces an experimental investigation of frictional behaviour of materials used for joint replacements. The measurements were performed using a ball-on-disc tribometer, while four material combinations were tested; metal-on-metal, ceramic-on-ceramic, metal-on-polyethylene, and ceramic-on-polyethylene, respectively. The contact was lubricated by pure saline and various protein solutions. The experiments were realized at two mean speeds equal to 5.7 mm/s and 22 mm/s and two slide-to-roll ratios, −150% and 150%. It was found that the implant material is the fundamental parameter affecting friction. In general, the metal pair exhibited approximately two times higher friction compared to the ceramic. In particular, the friction in the case of the metal varied between 0.3 and 0.6 while the ceramic pair exhibited friction within the range from 0.15 to 0.3 at the end of the test. The lowest friction was observed for polyethylene while it decreased to 0.05 under some conditions. It can be also concluded that adding proteins to the lubricant has a positive impact on friction in the case of hard-on-hard pairs. For hard-on-soft pairs, no substantial influence of proteins was observed. The effect of kinematic conditions was found to be negligible in most cases.

Enhanced lubricant film formation through micro-dimpled hard-on-hard artificial hip joint: An in-situ observation of dimple shape effects.

This study evaluates the impact of dimple shapes on lubricant film formation in artificial hip joints. Micro-dimples with 20-50 µm lateral size and 1 ±â€¯0.2 µm depths were fabricated on CrCoMo hip joint femoral heads using a picosecond laser. Tribological studies were performed using a pendulum hip joint simulator to apply continuous swing flexion-extension motions. The results revealed a significantly enhanced lubricant film thickness (≥ 500 nm) with micro-dimpled prosthesis heads at equilibrium position after the lubricant film has fully developed. The average lubricant film thickness of dimpled prostheses with square- and triangular-shaped dimple arrays over time is about 3.5 that of the non-dimpled prosthesis (204 nm). Remarkably, the prosthesis with square-shaped dimple arrays showed a very fast lubricant film formation reaching their peak values within 0.5 s of pendulum movement, followed by prosthesis with triangular-shaped dimple arrays with a transition period of 42.4 s. The fully developed lubricant film thicknesses (≥ 700 nm) are significantly higher than the surface roughness (≈ 25 nm) demonstrating a hydrodynamic lubrication. Hardly any scratches appeared on the post-experimental prosthesis with square-shaped dimple array and only a few scratches were found on the post-experimental prosthesis with triangular-shaped dimple arrays. Thus, prostheses with square-shaped dimple arrays could be a potential solution for durable artificial hip joints.

Mechanical wear and oxidative degradation analysis of retrieved ultra high molecular weight polyethylene acetabular cups.

The number of revision joint replacements has been increasing substantially over the last few years. Understanding their failure mechanism is extremely important for improving the design and material selection of current implants. This study includes ten retrieved and four new mildly cross-linked ultra-high molecular weight polyethylene (UHMWPE) acetabular liners. Among them, most of the prostheses (n = 5) were reported to be revised and replaced due to aseptic loosening, followed by painful joint (n = 2), dislocation (n = 1), intra articular ossification (n = 1), combination of wear (liner) and osteolysis (stem) (n=1). Surface deviations (wear, material inflation and roughness), oxidative degradation and change of material properties were measured using micro-computed tomography (micro-CT) scan, 3D laser scanning microscopy, raman spectroscopy and nanoindentation, respectively. Prostheses having eccentric worn areas had much higher linear wear rates (228.01 ± 35.51µm/year) compared to that of centrically worn prostheses (96.71 ± 10.83µm/year). Oxidation index (OI) showed similar trends to the surface penetration depth. Among them, sample 10 exhibited the highest OI across the contact area and the rim of the cup liner. It also had the lowest hardness/elasticity ratio. Overall, wear and creep, oxidative degradation and reduced hardness/elasticity ratio all contributed to the premature failure of the UHMWPE acetabular cup liners.

The impact of surface and geometry on coefficient of friction of artificial hip joints.

Coefficient of friction (COF) tests were conducted on 28-mm and 36-mm-diameter hip joint prostheses for four different material combinations, with or without the presence of Ultra High Molecular Weight Polyethylene (UHMWPE) particles using a novel pendulum hip simulator. The effects of three micro dimpled arrays on femoral head against a polyethylene and a metallic cup were also investigated. Clearance played a vital role in the COF of ceramic on polyethylene and ceramic on ceramic artificial hip joints. Micro dimpled metallic femoral heads yielded higher COF against a polyethylene cup; however, with metal on metal prostheses the dimpled arrays significantly reduced the COF. In situ images revealed evidence that the dimple arrays enhanced film formation, which was the main mechanism that contributed to reduced friction.

Characteristics of synovial fluid required for optimization of lubrication fluid for biotribological experiments.

Wear testing of total joint replacement (TJR) is mandatory in preclinical testing before implantation of TJR into the human body. Testing is governed by current international standards that recommend bovine serum (BS) as a lubricating fluid to replace synovial fluid (SF). Recently, the use of BS has been criticized because of differences in content, fluid characteristics, and nonhuman origin. As a result, a more realistic lubricant mimicking SF is needed. To define SF composition, we analyzed SF obtained during revisions of total hip and knee arthroplasties and compared it with SF obtained during primary arthroplasties and from patients without TJR. Samples were acquired from 152 patients. We found that the median total protein concentration for all SF was 36.8 mg/mL, which is significantly higher than concentrations currently recommended by the ISO standards. The γ-globulin concentration was significantly higher and the phospholipid concentration significantly lower in patients with revision of TJR compared with patients without TJR. No significant difference was found in hyaluronic acid concentration and viscosity among the groups. Our results support the need to improve the definition of a more clinically relevant wear testing lubricant in the ISO standards. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1422-1431, 2017.

The effect of lubricant constituents on lubrication mechanisms in hip joint replacements.

The aim of the present paper is to provide a novel experimental approach enabling to assess the thickness of lubricant film within hip prostheses in meaning of the contribution of particular proteins. Thin film colorimetric interferometry was combined with fluorescent microscopy finding that a combination of optical methods can help to better understand the interfacial lubrication processes in hip replacements. The contact of metal femoral head against a glass disc was investigated under various operating conditions. As a test lubricant, the saline solution containing the albumin and γ-globulin in a concentration 2:1 was employed. Two different mean speeds were applied, 5.7 and 22mm/s, respectively. The measurements were carried out under pure rolling, partial negative and partial positive sliding conditions showing that kinematic conditions substantially affects the formation of protein film. Under pure rolling conditions, an increasing tendency of lubricant film independently on rolling speed was detected, while the total thickness of lubricant film can be attributed mainly to albumin. When the ball was faster than the disc (negative sliding), a very thin lubricant film was observed for lower speed with no significant effect of particular proteins. The increase in sliding speed led to the increase of film thickness mainly caused due to the presence of γ-globulin. On the contrary, when the disc was faster than the ball (positive sliding), the film formation was very complex and time dependent while both of the studied proteins have shown any qualitative change during the test, however the effect of albumin seems to be much more important. Since a very good agreement of the results was obtained, it can be concluded that the approach consisting of two optical methods can provide the fundamental information about the lubricant film formation in meaning of particular proteins while the simultaneous presence of other constituents in model synovial fluid.

Towards near-permanent CoCrMo prosthesis surface by combining micro-texturing and low temperature plasma carburising.

An advanced surface engineering process combining micro-texture with a plasma carburising process was produced on CoCrMo femoral head, and their tribological properties were evaluated by the cutting-edge pendulum hip joint simulator coupled with thin film colorimetric interferometry. FESEM and GDOES showed that precipitation-free C S-phase with a uniform case depth of 10µm was formed across the micro-textures after duplex treatment. Hip simulator tests showed that the friction coefficient was reduced by 20% for micro-metre sized texture, and the long-term tribological property of microtexture was enhanced by the C-supersaturated crystalline microstructure formed on the surface of duplex treated CoCrMo, thereby enhancing biotribological durability significantly. In-situ colorimetric interferometry confirmed that the maximum film thickness around texture area was 530nm, indicating that the additional lubricant during sliding motion might provide exceptional bearing life.

A novel tribological study on DLC-coated micro-dimpled orthopedics implant interface.

This study investigates a tribological performance of diamond like carbon (DLC) coated micro dimpled prosthesis heads against ceramic cups in a novel pendulum hip joint simulator. The simulator enables determining friction coefficient and viscous effects of a concave shaped specimen interface (conformal contact). Two types of DLC such as hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) and one set of micro dimple (diameter of 300µm, depth of 70µm, and pitch of 900µm) were fabricated on metallic prosthesis heads. The experiment results reveal a significant friction coefficient reduction to the 'dimpled a-C:H/ceramic' prosthesis compared to a 'Metal (CoCr)/ceramic' prosthesis because of their improved material and surface properties and viscous effect. The post-experiment surface analysis displays that the dimpled a-C:H yielded a minor change in the surface roughness, and generated a larger sizes of wear debris (40-200nm sized, equivalent diameter), a size which could be certainly stored in the dimple, thus likely to reducing their possible third body abrasive wear rate. Thus, dimpled a:C-H can be used as a 'metal on ceramic hip joint interface', whereas the simulator can be utilized as an advanced bio-tribometer.

Fabrication and characterization of DLC coated microdimples on hip prosthesis heads.

Diamond like carbon (DLC) is applied as a thin film onto substrates to obtain desired surface properties such as increased hardness and corrosion resistance, and decreased friction and wear rate. Microdimple is an advanced surface modification technique enhancing the tribological performance. In this study, DLC coated microdimples were fabricated on hip prosthesis heads and their mechanical, material and surface properties were characterized. An Electro discharge machining (EDM) oriented microdrilling was utilized to fabricate a defined microdimple array (diameter of 300 µm, depth of 70 µm, and pitch of 900 µm) on stainless steel (SS) hip prosthesis heads. The dimpled surfaces were then coated by hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) layers by using a magnetron sputtering technology. A preliminary tribology test was conducted on these fabricated surfaces against a ceramic ball in simulated hip joint conditions. It was found that the fabricated dimples were perpendicular to the spherical surfaces and no cutting-tools wear debris was detected inside the individual dimples. The a-C:H and Ta-C coatings increased the hardness at both the dimple edges and the nondimpled region. The tribology test showed a significant reduction in friction coefficient for coated surfaces regardless of microdimple arrays: the lowest friction coefficient was found for the a-C:H samples (µ = 0.084), followed by Ta-C (µ = 0.119), as compared to the SS surface (µ = 0.248).

In situ measurements of thin films in bovine serum lubricated contacts using optical interferometry.

The aim of this study is to consider the relevance of in situ measurements of bovine serum film thickness in the optical test device that could be related to the function of the artificial hip joint. It is mainly focussed on the effect of the hydrophobicity or hydrophilicity of the transparent surface and the effect of its geometry. Film thickness measurements were performed using ball-on-disc and lens-on-disc configurations of optical test device as a function of time. Chromatic interferograms were recorded with a high-speed complementary metal-oxide semiconductor digital camera and evaluated with thin film colorimetric interferometry. It was clarified that a chromium layer covering the glass disc has a hydrophobic behaviour which supports the adsorption of proteins contained in the bovine serum solution, thereby a thicker lubricating film is formed. On the contrary, the protein film formation was not observed when the disc was covered with a silica layer having a hydrophilic behaviour. In this case, a very thin lubricating film was formed only due to the hydrodynamic effect. Metal and ceramic balls have no substantial effect on lubricant film formation although their contact surfaces have relatively different wettability. It was confirmed that conformity of contacting surfaces and kinematic conditions has fundamental effect on bovine serum film formation. In the ball-on-disc configuration, the lubricant film is formed predominantly due to protein aggregations, which pass through the contact zone and increase the film thickness. In the more conformal ball-on-lens configuration, the lubricant film is formed predominantly due to hydrodynamic effect, thereby the film thickness is kept constant during measurement.

Stress and strain analysis of the hip joint using FEM.

Many disorders of the hip can be treated with a suitable osteotomy based on the improvement of mechanical conditions in the hip joint. These operations, such as osteotomies are very complex. The surface replacement has also been developed as an alternative to a total hip replacement for young and more active people. It is up-to-date to concern with biomechanics of pathological hips and it is necessary to supplement the existing clinical findings with the results of mechanical analyses. Several finite element (FE) models are presented in this paper. The first one offers solutions to the strain-stress analysis of the physiological hip. The second one represents dysplastic hip joint. Another two computational models of both hips of a young patient were created (FE model of physiological hip and pathological hip affected by Perthes disease with a deformed shape of the femoral head). Also a computational model is presented, which enables us to investigate strain and stress parameters in the hip joint with applied surface replacement. The strain and stress analysis was performed by means of finite element method (FEM) in ANSYS system.