An investigation of the inelastic behaviour of trabecular bone during the press-fit implantation of a tibial component in total knee arthroplasty

Kelly, Niall P.; Cawley, Derek; Shannon, Fintan J.; McGarry, J. Patrick

doi:10.1016/j.medengphy.2013.05.007

Cited by 23 publications

(22 citation statements)

References 33 publications

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“…Distinct differences in compaction patterns were observed between tip designs, with flat tips generating a growing region of compacted material (referred to here as a bolus) directly below the tip, and sharp tips instead compacting material only along the sides of the indenter. Concentration of compacted material along the side of the indenter was consistent with the findings of similar push‐in studies in polyurethane foam . Large differences in density between human bone specimens, as well the extreme geometrical differences between tip designs, also provided a rigorous challenge for validation of the accuracy of the simulation.…”

Section: Discussionsupporting

confidence: 77%

Development and initial validation of a novel smoothed‐particle hydrodynamics‐based simulation model of trabecular bone penetration by metallic implants

Kulper

Fang

Ren

et al. 2017

Journal Orthopaedic Research

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A novel computational model of implant migration in trabecular bone was developed using smoothed-particle hydrodynamics (SPH), and an initial validation was performed via correlation with experimental data. Six fresh-frozen human cadaveric specimens measuring 10 × 10 × 20 mm were extracted from the proximal femurs of female donors (mean age of 82 years, range 75-90, BV/TV ratios between 17.88% and 30.49%). These specimens were then penetrated under axial loading to a depth of 10 mm with 5 mm diameter cylindrical indenters bearing either flat or sharp/conical tip designs similar to blunt and self-tapping cancellous screws, assigned in a random manner. SPH models were constructed based on microCT scans (17.33 µm) of the cadaveric specimens. Two initial specimens were used for calibration of material model parameters. The remaining four specimens were then simulated in silico using identical material model parameters. Peak forces varied between 92.0 and 365.0 N in the experiments, and 115.5-352.2 N in the SPH simulations. The concordance correlation coefficient between experimental and simulated pairs was 0.888, with a 95%CI of 0.8832-0.8926, a Pearson ρ (precision) value of 0.9396, and a bias correction factor Cb (accuracy) value of 0.945. Patterns of bone compaction were qualitatively similar; both experimental and simulated flat-tipped indenters produced dense regions of compacted material adjacent to the advancing face of the indenter, while sharp-tipped indenters deposited compacted material along their peripheries. Simulations based on SPH can produce accurate predictions of trabecular bone penetration that are useful for characterizing implant performance under high-strain loading conditions. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1114-1123, 2018.

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Section: Discussionsupporting

confidence: 77%

Development and initial validation of a novel smoothed‐particle hydrodynamics‐based simulation model of trabecular bone penetration by metallic implants

Kulper

Fang

Ren

et al. 2017

Journal Orthopaedic Research

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“…In combination with current bone plasticity formulations (Kelly et al, 2013;Kinzl et al, 2013), the results of the present study will help to improve numerical press-fit models with porous surfaces by a better estimation of the applied interference (due to numerically including the abrasion) and accounting for the nonconstant friction coefficient during implantation. This could improve the estimation of primary implant stability derived from finite element models.…”

Section: Discussionmentioning

confidence: 93%

Friction coefficient and effective interference at the implant-bone interface

Damm

Morlock

Bishop

2015

Journal of Biomechanics

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“…Models using idealised material properties may capture gross differences, but are unlikely to capture subtle variations and localised effects. Bone is routinely assumed to be isotropic and linear elastic, except for some instances which have implemented anisotropy (Taylor et al, 2002;Hazrati Marangalou et al, 2013) and post-yield behaviour (Taylor et al, 1995;Kelly et al, 2013;Janssen et al, 2010;. These assumptions of linear and isotropic material behaviour are, in part, due to the limited information that can be extracted from clinical grade CT scans.…”

Section: Development Of a Representative Model With Appropriate Loadmentioning

confidence: 99%

“…Bone ingrowth/ ongrowth will occur if the micromotions are less than 40-50 μm and fibrous tissue formation will occur if the micromotions are in excess of 150 μm (Pilliar et al, 1986). FE has been extensively to analysis the primary stability of femoral stems (Tensi et al, 1989;Rohlmann et al, 1988; (Udofia et al, 2007;Spears et al, 2001;Janssen et al, 2010;Ries et al, 1997;Spears et al, 1999Spears et al, , 2000Ong et al, 2006;Bellini et al, 2007;Amirouche et al, 2008;Hothi et al, 2011Hothi et al, , 2012 and the tibial component of knee replacement Chong et al, 2010;Kelly et al, 2013;Taylor et al, 1998) since Rohlmann et al, 1988 first explored primary stability. A number of assumptions have become accepted and routinely implemented.…”

Section: Simulation Of the Initial Mechanical Environment Of The Bonementioning

confidence: 99%

“…Most studies assume that the supporting bone is linear elastic (Chong et al, 2010;Reggiani et al, 2008;Abdul-Kadir et al, 2008;Bah et al, 2011), despite some studies reporting stresses that approach or exceed the yield stress (Taylor et al, 1995;Kelly et al, 2013;Rohlmann et al, 1988;Ong et al, 2006;Hothi et al, 2011;Rothstock et al, 2010). In addition, the viscoelastic properties will lead to stress relaxation, particularly if an interference fit is simulated.…”

Section: Simulation Of the Initial Mechanical Environment Of The Bonementioning

confidence: 99%

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

Taylor

Prendergast

2015

Journal of Biomechanics

146

106

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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.

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An investigation of the inelastic behaviour of trabecular bone during the press-fit implantation of a tibial component in total knee arthroplasty

Cited by 23 publications

References 33 publications

Development and initial validation of a novel smoothed‐particle hydrodynamics‐based simulation model of trabecular bone penetration by metallic implants

Development and initial validation of a novel smoothed‐particle hydrodynamics‐based simulation model of trabecular bone penetration by metallic implants

Friction coefficient and effective interference at the implant-bone interface

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

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