Numerous numerical methods have been developed in an effort to accurately predict stresses in bones. The largest group are variants of the h-version of the finite element method (h-FEM), where low order Ansatz functions are used. By contrast, we3 investigate a combination of high order FEM and a fictitious domain approach, the finite cell method (FCM). While the FCM has been verified and validated in previous publications, this article proposes methods on how the FCM can be made computationally efficient to the extent that it can be used for patient specific, interactive bone simulations. This approach is called computa-