Long-term study of bone remodelling after femoral stem: A comparison between dexa and finite element simulation

Herrera, Antonio; Panisello, Juan J.; Ibarz, Elena; Cegoñino, José; Puértolas, J.A.; Gracia, Luis

doi:10.1016/j.jbiomech.2007.06.008

Cited by 59 publications

(56 citation statements)

References 49 publications

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“…This is an advancement on other studies that have used imaging modalities such as DEXA [15,16,22,23], which cannot distinguish between cortical and cancellous bone. Kerner et al [16] used DEXA combined with FE to test the bone remodelling algorithm previously published by Huiskes et al [24].…”

Section: Discussionmentioning

confidence: 99%

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Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem

Shim

Pitto

Anderson

2012

International Orthopaedics (SICOT)

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Purpose We used quantitative CT in conjunction with finite element analysis to provide a new tool for assessment of bone quality after total hip arthroplasty in vivo. The hypothesis of this prospective five-year study is that the combination of the two modalities allows 3D patientspecific imaging of cortical and cancellous bone changes and stress shielding. Method We tested quantitative CT in conjunction with finite elements on a cohort of 29 patients (31 hips) who have been scanned postoperatively and at one year, two years and five years follow-up. The method uses cubic Hermite finite element interpolation for efficient mesh generation directly from qCT datasets. The element Gauss points that are used for the geometric interpolation functions are also used for interpolation of osteodensitometry data. Results The study showed changes of bone density suggestive of proximal femur diaphysis load transfer with osteointegration and moderate metaphyseal stress shielding. Our model revealed that cortical bone initially became porous in the greater trochanter, but this phenomenon progressed to the cortex of the lesser trochanter and the posterior aspect of the metaphysis. The diaphyseal area did not experience major change in bone density for either cortical or cancellous bone. Conclusion The combination of quantitative CT with finite element analysis allows visualization of changes to bone density and architecture. It also provides correlation of bone density/architectural changes with stress patterns enabling the study of the effects of stress shielding on bone remodelling in vivo. This technology can be useful in predicting bone remodeling and the quality of implant fixation using prostheses with different design and/or biomaterials.

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Section: Discussionmentioning

confidence: 99%

“…This enabled us to perform much more detailed comparisons than similar studies which were based on either Gruen Zones or some arbitrary regions of interest [15][16][17]. This approach has been validated with in-vitro mechanical experiment [12,18].…”

Section: Methodsmentioning

confidence: 97%

Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem

Shim

Pitto

Anderson

2012

International Orthopaedics (SICOT)

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“…Other groups have evaluated the agreement between FE predictions and DXA measurements (Herrera et al 2007;Herrera et al 2014;ten Broeke et al 2014), although to obtain a close fit these models require retrospective tuning. This is acknowledged as a limitation of the present study to a degree, although with the exception of the threshold remodelling stimulus, all parameters used in this approach were selected from the surgical and rehabilitation biomechanics literature and are representative of external factors only.…”

Section: Discussionmentioning

confidence: 99%

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Dickinson

2015

Biomech Model Mechanobiol

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Bone morphology and density changes are commonly observed following joint replacement, and may contribute to the risks of implant loosening and periprosthetic fracture, and reduce the available bone stock for revision surgery. This study was presented in the "Bone and Cartilage Mechanobiology across the scales" WCCM symposium to review the development of remodelling prediction methods and to demonstrate simulation of adaptive bone remodelling around hip replacement femoral components, incorporating intrinsic (prosthesis) and extrinsic (activity and loading) factors.An iterative bone remodelling process was applied to finite element models of a femur implanted with a cementless THR (total hip replacement) and a hip resurfacing implant. Previously developed for a cemented THR implant, this modified process enabled the influence of pre-to postoperative changes in patient activity and joint loading to be evaluated. A control algorithm used identical pre-and postoperative conditions, and the predicted extents and temporal trends of remodelling were measured by generating virtual x-rays and DXA scans.The modified process improved qualitative and quantitative remodelling predictions for both the cementless THR and resurfacing implants, but demonstrated the sensitivity to DXA scan region definition and appropriate implant-bone position and sizing. Predicted remodelling in the intact femur in response to changed activity and loading demonstrated that in this simplified model, although the influence of the extrinsic effects were important, the mechanics of implantation were dominant. This study supports the application of predictive bone remodelling as one element in the range of physical and computational studies, which should be conducted in the pre-clinical evaluation of new prostheses.

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“…11). Three boundary conditions were defined: clamped in the medial diaphyseal part of the femur, force on the prosthetic head due to the reaction of the hip caused by the weight of the person (400% body weight) and force on the greater trochanter (200% body weight) generated by the abductor muscles (Herrera et al, 2007).…”

Section: Fig 8 Gruen Zonesmentioning

confidence: 99%

Simulation by Finite Elements of Bone Remodeling After Implantation of Femoral Stems

Gracia¹,

Ibarz²,

Cegoñino³

et al. 2012

Finite Element Analysis - From Biomedical Applications to Industrial Developments

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Long-term study of bone remodelling after femoral stem: A comparison between dexa and finite element simulation

Cited by 59 publications

References 49 publications

Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem

Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Simulation by Finite Elements of Bone Remodeling After Implantation of Femoral Stems

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