Peri-implant bone microstructure determines dynamic implant cut-out

Basler, S.E.; Traxler, J.; Müller, Ralph; Lenthe, G. Harry van

doi:10.1016/j.medengphy.2013.03.016

Cited by 22 publications

(23 citation statements)

References 36 publications

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“…For this purpose, metal replicas, such as Polyetheretherketon (PEEK), would have to be used instead to avoid metal artefacts during scanning. Such studies have already been performed recently [41][42][43] and have shown good agreement for displacements between the ex vivo and in silico measurements on the local level. 41 In conclusion, this study presented mFE analyses of a multi-screw fracture fixation device placed in the human proximal humerus for patient-specific quantification of primary implant stability in human bone.…”

Section: Discussionmentioning

confidence: 73%

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Patient‐specific in silico models can quantify primary implant stability in elderly human bone

Steiner

Hofmann

Christen

et al. 2017

Journal Orthopaedic Research

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Secure implant fixation is challenging in osteoporotic bone. Due to the high variability in inter- and intra-patient bone quality, ex vivo mechanical testing of implants in bone is very material- and time-consuming. Alternatively, in silico models could substantially reduce costs and speed up the design of novel implants if they had the capability to capture the intricate bone microstructure. Therefore, the aim of this study was to validate a micro-finite element model of a multi-screw fracture fixation system. Eight human cadaveric humerii were scanned using micro-CT and mechanically tested to quantify bone stiffness. Osteotomy and fracture fixation were performed, followed by mechanical testing to quantify displacements at 12 different locations on the instrumented bone. For each experimental case, a micro-finite element model was created. From the micro-finite element analyses of the intact model, the patient-specific bone tissue modulus was determined such that the simulated apparent stiffness matched the measured stiffness of the intact bone. Similarly, the tissue modulus of a small damage region around each screw was determined for the instrumented bone. For validation, all in silico models were rerun using averaged material properties, resulting in an average coefficient of determination of 0.89 ± 0.04 with a slope of 0.93 ± 0.19 and a mean absolute error of 43 ± 10 μm when correlating in silico marker displacements with the ex vivo test. In conclusion, we validated a patient-specific computer model of an entire organ bone-implant system at the tissue-level at high resolution with excellent overall accuracy. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:954-962, 2018.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 76%

Patient‐specific in silico models can quantify primary implant stability in elderly human bone

Steiner

Hofmann

Christen

et al. 2017

Journal Orthopaedic Research

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“…The load transfer from metal implant to bone is an important issue in biomechanics (Mueller, et al, 2009). Since bone consists of dense cortical bone and inner porous trabecular bone (or cancellous bone) with very complex 3D microarchitecture, it is important to consider the peri-implant trabecular bone (Basler, et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Multiscale stress analysis of trabecular bone around acetabular cup implant by finite element mesh superposition method

Tsukino¹,

Takano²,

Michel

et al. 2015

Mechanical Engineering Letters

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Microscopic stress was calculated with 0.017 mm resolution in a macroscopic model with approximately 100 mm size using the finite element mesh superposition method. To bridge the large gap in resolution, an intermediate finite element model was newly used. This multiscale computational procedure was applied to the biomechanical problem to analyze the microscopic stress in the trabecular bone around acetabular cup implant in total hip arthroplasty, which occurs by direct contact of the implant with trabecular bone. In the microstructural modeling of highly porous media such as the trabecular bone, special attention was paied to the boundary of microstructure model for both homogenization procedure and mesh superposition procedure. Three demonstrative numerical results revealed that higher stress occured at microscale due to macroscopic stress concentration, which is hardly estimated by only bone volume fraction.

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“…Clear‐cut clinical evidence that osteoporosis has a negative impact on implantation is still lacking . Nevertheless, biomechanical experiments suggest that implant anchorage may be compromised in osteoporotic bone …”

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confidence: 99%

“…9,10 Nevertheless, biomechanical experiments suggest that implant anchorage may be compromised in osteoporotic bone. [11][12][13][14] Initial implant stability is of paramount importance for the biological events following implantation and leading to osseointegration, defined as direct formation of bone tissue in contact with the implant. 15,16 Once osseointegration is achieved, the long-term stability of the implant is maintained by bone remodeling, 17 traditionally described as bone resorption followed by formation at the same site.…”

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confidence: 99%

Bone remodeling and mechanobiology around implants: Insights from small animal imaging

Müller

Ruffoni

2017

Journal Orthopaedic Research

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Anchorage of orthopedic implants depends on the interfacial bonding between the implant and the host bone as well as on the mass and microstructure of peri-implant bone, with all these factors being continuously regulated by the biological process of bone (re)modeling. In osteoporotic bone, implant integration may be jeopardized not only by lower peri-implant bone quality but also by reduced intrinsic regeneration ability. The first aim of this review is to provide a critical overview of the influence of osteoporosis on bone regeneration post-implantation. Mechanical stimulation can trigger bone formation and inhibit bone resorption; thus, judicious administration of mechanical loading can be used as an effective non-pharmacological treatment to enhance implant anchorage. Our second aim is to report recent achievements on the application of external mechanical stimulation to improve the quantity of periimplant bone. The review focuses on peri-implant bone changes in osteoporotic conditions and following mechanical loading, prevalently using small animals and in vivo monitoring approaches. We intend to demonstrate the necessity to reveal new biological information on peri-implant bone mechanobiology to better target implant anchorage and fracture fixation in osteoporotic conditions. ß

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Peri-implant bone microstructure determines dynamic implant cut-out

Cited by 22 publications

References 36 publications

Patient‐specific in silico models can quantify primary implant stability in elderly human bone

Patient‐specific in silico models can quantify primary implant stability in elderly human bone

Multiscale stress analysis of trabecular bone around acetabular cup implant by finite element mesh superposition method

Bone remodeling and mechanobiology around implants: Insights from small animal imaging

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