Details
| Original language | English |
|---|---|
| Pages (from-to) | 2351-2356 |
| Number of pages | 6 |
| Journal | International orthopaedics |
| Volume | 37 |
| Issue number | 12 |
| Publication status | Published - 31 Aug 2013 |
Abstract
Purpose: For further development of better bone-preserving implants in total hip arthroplasty (THA), we need to look back and analyse established and clinically approved implants to find out what made them successful. Finite element analysis can help do this by simulating periprosthetic bone remodelling under different conditions. Our aim was thus to establish a numerical model of the cementless straight stem for which good long-term results have been obtained. Methods: We performed a numeric simulation of a cementless straight stem, which has been successfully used in its unaltered form since 1986/1987. We have 20 years of experience with this THA system and implanted it 555 times in 2012. We performed qualitative and quantitative validation using bone density data derived from a prospective dual-energy X-ray absorptiometry (DEXA) investigation. Results: Bone mass loss converged to 9.25 % for the entire femur. No change in bone density was calculated distal to the tip of the prosthesis. Bone mass decreased by 46.2 % around the proximal half of the implant and by 7.6 % in the diaphysis. The numeric model was in excellent agreement with DEXA data except for the calcar region, where deviation was 67.7 %. Conclusions: The higher deviation in the calcar region is possibly a sign of the complex interactions between the titanium coating on the stem and the surrounding bone. We developed a validated numeric model to simulate bone remodelling for different stem-design modifications. We recommend that new THA implants undergo critical numeric simulation before clinical application.
Keywords
- Bone remodelling, Dual-energy X-ray absorptiometry, Finite element analysis, Stress shielding, Total hip arthroplasty
ASJC Scopus subject areas
- Medicine(all)
- Surgery
- Medicine(all)
- Orthopedics and Sports Medicine
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In: International orthopaedics, Vol. 37, No. 12, 31.08.2013, p. 2351-2356.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Numeric simulation of bone remodelling patterns after implantation of a cementless straight stem
AU - Lerch, Matthias
AU - Windhagen, Henning
AU - Stukenborg-Colsman, Christina M.
AU - Kurtz, Agnes
AU - Behrens, Bernd A.
AU - Almohallami, Amer
AU - Bouguecha, Anas
N1 - Funding information: Acknowledgments The study was part of subproject D6 of the Collaborative Research Center 599 “Sustainable degradable and permanent implants out of metallic and ceramic materials”. The authors thank the German Research Foundation for financial support.
PY - 2013/8/31
Y1 - 2013/8/31
N2 - Purpose: For further development of better bone-preserving implants in total hip arthroplasty (THA), we need to look back and analyse established and clinically approved implants to find out what made them successful. Finite element analysis can help do this by simulating periprosthetic bone remodelling under different conditions. Our aim was thus to establish a numerical model of the cementless straight stem for which good long-term results have been obtained. Methods: We performed a numeric simulation of a cementless straight stem, which has been successfully used in its unaltered form since 1986/1987. We have 20 years of experience with this THA system and implanted it 555 times in 2012. We performed qualitative and quantitative validation using bone density data derived from a prospective dual-energy X-ray absorptiometry (DEXA) investigation. Results: Bone mass loss converged to 9.25 % for the entire femur. No change in bone density was calculated distal to the tip of the prosthesis. Bone mass decreased by 46.2 % around the proximal half of the implant and by 7.6 % in the diaphysis. The numeric model was in excellent agreement with DEXA data except for the calcar region, where deviation was 67.7 %. Conclusions: The higher deviation in the calcar region is possibly a sign of the complex interactions between the titanium coating on the stem and the surrounding bone. We developed a validated numeric model to simulate bone remodelling for different stem-design modifications. We recommend that new THA implants undergo critical numeric simulation before clinical application.
AB - Purpose: For further development of better bone-preserving implants in total hip arthroplasty (THA), we need to look back and analyse established and clinically approved implants to find out what made them successful. Finite element analysis can help do this by simulating periprosthetic bone remodelling under different conditions. Our aim was thus to establish a numerical model of the cementless straight stem for which good long-term results have been obtained. Methods: We performed a numeric simulation of a cementless straight stem, which has been successfully used in its unaltered form since 1986/1987. We have 20 years of experience with this THA system and implanted it 555 times in 2012. We performed qualitative and quantitative validation using bone density data derived from a prospective dual-energy X-ray absorptiometry (DEXA) investigation. Results: Bone mass loss converged to 9.25 % for the entire femur. No change in bone density was calculated distal to the tip of the prosthesis. Bone mass decreased by 46.2 % around the proximal half of the implant and by 7.6 % in the diaphysis. The numeric model was in excellent agreement with DEXA data except for the calcar region, where deviation was 67.7 %. Conclusions: The higher deviation in the calcar region is possibly a sign of the complex interactions between the titanium coating on the stem and the surrounding bone. We developed a validated numeric model to simulate bone remodelling for different stem-design modifications. We recommend that new THA implants undergo critical numeric simulation before clinical application.
KW - Bone remodelling
KW - Dual-energy X-ray absorptiometry
KW - Finite element analysis
KW - Stress shielding
KW - Total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84890567437&partnerID=8YFLogxK
U2 - 10.1007/s00264-013-2072-5
DO - 10.1007/s00264-013-2072-5
M3 - Article
C2 - 23995334
AN - SCOPUS:84890567437
VL - 37
SP - 2351
EP - 2356
JO - International orthopaedics
JF - International orthopaedics
SN - 0341-2695
IS - 12
ER -