Primary stability of custom and anatomical uncemented femoral stems

Østbyhaug, Per Olav; Klaksvik, Jomar; Romundstad, Pål; Aamodt, Arild

doi:10.1016/j.clinbiomech.2009.12.012

Cited by 38 publications

(16 citation statements)

References 28 publications

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“…In the presented experimental testing set-up and in accordance with previous reports (26,31,64,72) the physiological load applied to the femoral bone was reduced to a simpler con guration, where only the abductors were included. Despite the complexity of the biomechanics involving the hip, recent in-vitro biomechanical studies evaluating femoral prostheses tend to be as simple as possible, not fully accounting for the numerous soft-tissue interactions which actively contribute to hip joint stability and femoral loading characteristics.…”

Section: Discussionmentioning

confidence: 85%

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Tatani

Megas

Παναγόπουλος

et al. 2020

Preprint

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Background: The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants, the TRI-LOCK Bone Preservation Stem, a shortened conventional stem and the Minima S Femoral Stem, an even shorter and anatomically shaped stem, based on experiments and numerical simulations. Furthermore, finite element models of implant–bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique. Results: Design differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses revealed a reasonable agreement between the numerical and experimental data in the majority of cases. Conclusion: The study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, a proximal stress shielding effect was noted after the implantation of both short stem designs. Design specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.

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Section: Discussionmentioning

confidence: 85%

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Tatani

Megas

Παναγόπουλος

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In this study, where a direct comparison between two implant systems was made, the proven low inter-specimen variability of composite femurs can provide more consistent results, eliminating confounding factors. In the presented experimental testing setup and in accordance with previous reports [26,31,64,72] the physiological load applied to the femoral bone was reduced to a simpler configuration, where only the abductors were included. Despite the complexity of the biomechanics involving the hip, recent in vitro biomechanical studies evaluating femoral prostheses tend to be as simple as possible, not fully accounting for the numerous soft-tissue interactions which actively contribute to hip joint stability and femoral loading characteristics.…”

Section: Discussionmentioning

confidence: 87%

Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation

et al. 2020

View full text Add to dashboard Cite

Background: The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding. This study aims to investigate the biomechanical properties of two distinctly designed femoral implants, the TRI-LOCK Bone Preservation Stem, a shortened conventional stem and the Minima S Femoral Stem, an even shorter and anatomically shaped stem, based on experiments and numerical simulations. Furthermore, finite element models of implant-bone constructs should be evaluated for their validity against mechanical tests wherever it is possible. In this work, the validation was performed via a direct comparison of the FE calculated strain fields with their experimental equivalents obtained using the digital image correlation technique. Results: Design differences between Trilock BPS and Minima S femoral stems conditioned different strain pattern distributions. A distally shifting load distribution pattern as a result of implant insertion and also an obvious decrease of strain in the medial proximal aspect of the femur was noted for both stems. Strain changes induced after the implantation of the Trilock BPS stem at the lateral surface were greater compared to the non-implanted femur response, as opposed to those exhibited by the Minima S stem. Linear correlation analyses revealed a reasonable agreement between the numerical and experimental data in the majority of cases. Conclusion: The study findings support the use of DIC technique as a preclinical evaluation tool of the biomechanical behavior induced by different implants and also identify its potential for experimental FE model validation. Furthermore, a proximal stress-shielding effect was noted after the implantation of both short-stem designs. Design-specific variations in short stems were sufficient to produce dissimilar biomechanical behaviors, although their clinical implication must be investigated through comparative clinical studies.

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“…In recent year, similar results for the hip replacement implant are exhibited in [56,57]. Micro-motion in excess of 150 μm will compromise the structural integrity of the bone-implant system and lead to unsuccessful osseointegration to undertake load-bearing period (rehabilitation period).…”

Section: Stability Of Osseointegrated Implantmentioning

confidence: 81%

“…Micro-motion in excess of 150 μm will compromise the structural integrity of the bone-implant system and lead to unsuccessful osseointegration to undertake load-bearing period (rehabilitation period). Moreover, insufficient primary stability will hinder the initial healing, leading to fibrous tissue formation rather than bone formation [54,57,58]. The secondary stability, which is the result of bone healing and remodelling, is highly reliant on the state of osseointegration [59].…”

Section: Stability Of Osseointegrated Implantmentioning

confidence: 99%

Non-radiative healing assessment techniques for fractured long bones and osseointegrated implant

Vien

Russ

et al. 2019

Biomed. Eng. Lett.

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The paper provides an overview of the fracture healing process of long bones, a review of work that proposed appropriate physical parameters for the assessment of healing and highlights some recent work that reported on the development of non-radiative technique for healing assessment. An overview of the development and monitoring of osseointegration for trans-femoral osseointegrated implant is also presented. The state of healing of a fractured long bone and the stability of osseointegrated implants can be seen as engineering structural components where the mechanical properties are restored to facilitate their desired function. To this end, this paper describes non-radiative techniques that are useful for healing assessment and the stability assessment of osseointegrated implants. The achievement of non-radiative quantitative assessment methodologies to determine the state of healing of fractured long bones and to assess the stability of osseointegrated implant will shorten the patient's rehabilitation time, allowing earlier mobility and return to normal activities. Recent work on the development of assessment techniques supported by the Office of Naval Research as part of the Monitoring of Osseointegrated Implant Prosthesis program is highlighted.

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Primary stability of custom and anatomical uncemented femoral stems

Cited by 38 publications

References 28 publications

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Comparative Analysis of the Biomechanical Behavior of two different design metaphyseal-fitting short stems using digital image correlation

Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation

Non-radiative healing assessment techniques for fractured long bones and osseointegrated implant

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