A large scale finite element study of a cementless osseointegrated tibial tray

Galloway, Francis; Kahnt, Max; Ramm, Heiko; Worsley, Peter; Zachow, Stefan; Nair, Prasanth B.; Taylor, Mark

doi:10.1016/j.jbiomech.2013.04.021

Cited by 51 publications

(44 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the study does not include precise patient specific loading and activity profiles, it demonstrates the importance of accounting for them, and supports recent work for single timepoint models which incorporate both population modeling of bone geometry and materials, and of load profiles [51]. The use of individual bone models (i.e., « = 1) is a common limitation to iterative, adaptive bone remodeling studies owing to computational expense.…”

Section: Journai Of Biomechanical Engineeringsupporting

confidence: 62%

Activity and Loading Influence the Predicted Bone Remodeling Around Cemented Hip Replacements

Dickinson

2014

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

Periprosthetic bone remodeling is frequently observed after total hip replacement. Reduced bone density increases the implant and bone fracture risk, and a gross loss of bone density challenges fixation in subsequent revision surgery. Computational approaches allow bone remodeling to be predicted in agreement with the general clinical observations of proximal resorption and distal hypertrophy. However, these models do not reproduce other clinically observed bone density trends, including faster stabilizing mid-stem density losses, and loss-recovery trends around the distal stem. These may resemble trends in postoperative joint loading and activity, during recovery and rehabilitation, but the established remodeling prediction approach is often used with identical pre- and postoperative load and activity assumptions. Therefore, this study aimed to evaluate the influence of pre- to postoperative changes in activity and loading upon the predicted progression of remodeling. A strain-adaptive finite element model of a femur implanted with a cemented Charnley stem was generated, to predict 60 months of periprosthetic remodeling. A control set of model input data assumed identical pre- and postoperative loading and activity, and was compared to the results obtained from another set of inputs with three varying activity and load profiles. These represented activity changes during rehabilitation for weak, intermediate and strong recoveries, and pre- to postoperative joint force changes due to hip center translation and the use of walking aids. Predicted temporal bone density change trends were analyzed, and absolute bone density changes and the time to homeostasis were inspected, alongside virtual X-rays. The predicted periprosthetic bone density changes obtained using modified loading inputs demonstrated closer agreement with clinical measurements than the control. The modified inputs also predicted the clinically observed temporal density change trends, but still under-estimated density loss during the first three postoperative months. This suggests that other mechanobiological factors have an influence, including the repair of surgical micro-fractures, thermal damage and vascular interruption. This study demonstrates the importance of accounting for pre- to postoperative changes in joint loading and patient activity when predicting periprosthetic bone remodeling. The study's main weakness is the use of an individual patient model; computational expense is a limitation of all previously reported iterative remodeling analysis studies. However, this model showed sufficient computational efficiency for application in probabilistic analysis, and is an easily implemented modification of a well-established technique.

show abstract

Section: Journai Of Biomechanical Engineeringsupporting

confidence: 62%

Activity and Loading Influence the Predicted Bone Remodeling Around Cemented Hip Replacements

Dickinson

2014

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

show abstract

“…Ideally mesh convergence would be performed on every model produced, but that is usually not practical. Choosing a representative model for convergence is consistent with the methods of other automated modeling techniques in the literature (Bischoff et al, 2014;Galloway et al, 2013).…”

Section: Discussionmentioning

confidence: 58%

Automated finite element meshing of the lumbar spine: Verification and validation with 18 specimen-specific models

Campbell

Coombs

Rao³

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

The purpose of this study was to seek broad verification and validation of human lumbar spine finite element models created using a previously published automated algorithm. The automated algorithm takes segmented CT scans of lumbar vertebrae, automatically identifies important landmarks and contact surfaces, and creates a finite element model. Mesh convergence was evaluated by examining changes in key output variables in response to mesh density. Semi-direct validation was performed by comparing experimental results for a single specimen to the automated finite element model results for that specimen with calibrated material properties from a prior study. Indirect validation was based on a comparison of results from automated finite element models of 18 individual specimens, all using one set of generalized material properties, to a range of data from the literature. A total of 216 simulations were run and compared to 186 experimental data ranges in all six primary bending modes up to 7.8Nm with follower loads up to 1000N. Mesh convergence results showed less than a 5% difference in key variables when the original mesh density was doubled. The semi-direct validation results showed that the automated method produced results comparable to manual finite element modeling methods. The indirect validation results showed a wide range of outcomes due to variations in the geometry alone. The studies showed that the automated models can be used to reliably evaluate lumbar spine biomechanics, specifically within our intended context of use: in pure bending modes, under relatively low non-injurious simulated in vivo loads, to predict torque rotation response, disc pressures, and facet forces.

show abstract

“…A high proportion of all FE studies only examine representations of the early post-operative mechanical environment and these predictions also act as the basis for time based, adaptive simulations and errors made in the first iteration will propagate through these time based solutions. Some of the early FE studies of cemented hip stems (Huiskes, 1990;Crowninshield et al, 1980;Prendergast et al, 1989) assumed idealised cement mantle geometry, no interdigitation of the cement into cancellous bone and elastic properties for the cement and these assumptions are still routinely used today (Taddei et al, 2010;Galloway et al, 2013;Pal et al, 2009;Ramos et al, 2013). One of the main challenges is that the mechanical behaviour of the cement (Whitehouse and Evans, 2010) and of the stem-cement and cementbone interfaces are still poorly understood, largely due to a lack of experimental data.…”

Section: Simulation Of the Initial Mechanical Environment Of The Bonementioning

confidence: 99%

Four decades of finite element analysis of orthopaedic devices: Where are we now and what are the opportunities?

Taylor

Prendergast

2015

Journal of Biomechanics

Self Cite

146

106

View full text Add to dashboard Cite

a b s t r a c tFinite element has been used for more than four decades to study and evaluate the mechanical behaviour total joint replacements. In Huiskes seminal paper "Failed innovation in total hip replacement: diagnosis and proposals for a cure", finite element modelling was one of the potential cures to avoid poorly performing designs reaching the market place. The size and sophistication of models has increased significantly since that paper and a range of techniques are available from predicting the initial mechanical environment through to advanced adaptive simulations including bone adaptation, tissue differentiation, damage accumulation and wear. However, are we any closer to FE becoming an effective screening tool for new devices? This review contains a critical analysis of currently available finite element modelling techniques including (i) development of the basic model, the application of appropriate material properties, loading and boundary conditions, (ii) describing the initial mechanical environment of the bone-implant system, (iii) capturing the time dependent behaviour in adaptive simulations, (iv) the design and implementation of computer based experiments and (v) determining suitable performance metrics.The development of the underlying tools and techniques appears to have plateaued and further advances appear to be limited either by a lack of data to populate the models or the need to better understand the fundamentals of the mechanical and biological processes. There has been progress in the design of computer based experiments. Historically, FE has been used in a similar way to in vitro tests, by running only a limited set of analyses, typically of a single bone segment or joint under idealised conditions. The power of finite element is the ability to run multiple simulations and explore the performance of a device under a variety of conditions. There has been increasing usage of design of experiments, probabilistic techniques and more recently population based modelling to account for patient and surgical variability. In order to have effective screening methods, we need to continue to develop these approaches to examine the behaviour and performance of total joint replacements and benchmark them for devices with known clinical performance.Finite element will increasingly be used in the design, development and pre-clinical testing of total joint replacements. However, simulations must include holistic, closely corroborated, multi-domain analyses which account for real world variability.

show abstract

A large scale finite element study of a cementless osseointegrated tibial tray

Cited by 51 publications

References 35 publications

Activity and Loading Influence the Predicted Bone Remodeling Around Cemented Hip Replacements

Activity and Loading Influence the Predicted Bone Remodeling Around Cemented Hip Replacements

Automated finite element meshing of the lumbar spine: Verification and validation with 18 specimen-specific models

Four decades of finite element analysis of orthopaedic devices: Where are we now and what are the opportunities?

Contact Info

Product

Resources

About