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Through FEM analysis, a global graphical output around the hip joint can provide simple impression of stress distribution: concentration or dispersion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 32 hips with ARCO stage 2 or 3 ONFH who were on follow up for over a one-year period were retrospectively reviewed. 16 hips with no interval progression of collapse were set as the study group, then 16 hips with progression of collapse which required arthroplasty were set as the control group using propensity-score matching. FEM was generated through Mechanical Finder for each patient, then 4500\u00a0N of load was applied to 1000 mm\n                      <jats:sup>2<\/jats:sup>\n                      area at the top of iliac crest to analyze the models in terms of equivalents for yield stress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age, sex, and BMI had no significant differences between the two groups, while location (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) was lateral, and size (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) was significantly greater in the collapsed group. Non-collapsed hips mostly exhibited stress dispersion allocated to medial and lateral pillars, while collapsed hips exhibited stress concentration focused on the lateral pillar and the primary compression trabecula. (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Through FEM analysis, stress concentration to the lateral pillar and the primary compression trabeculae can be used to predict future collapse in ONFH with high probability. Results provide a simple and intuitive, yet valuable information to aid surgeons. Therefore, especially for young patients, holding out the lateral pillar through joint preserving procedures might be the key in preventing further collapse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-021-02875-8","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T05:03:12Z","timestamp":1639976592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Lateral pillar is the key in supporting pre-collapse osteonecrosis of the femoral head: a finite element model analysis of propensity-score matched cohorts"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-3220","authenticated-orcid":false,"given":"Ji Hoon","family":"Bahk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-9348","authenticated-orcid":false,"given":"Woo-Lam","family":"Jo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1626-5383","authenticated-orcid":false,"given":"Seung-Chan","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-956X","authenticated-orcid":false,"given":"Soon-Yong","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5648-9755","authenticated-orcid":false,"given":"Young Wook","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"2875_CR1","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-1053.R1","volume":"101","author":"S Kim","year":"2019","unstructured":"Kim S, Lim Y, Kwon S, Jo W, Heu J, Kim Y. 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Approval was granted and informed consent was waived by the Institutional Review Board of Seoul St. Mary\u2019s Hospital (November 9, 2020, No. KC20RISI0276).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"728"}}