Current interactive computing state-of-the-art environments, libraries, and frameworks open the door for engineers to run their simulation codes in an interactive mode, i. e. allowing for estimations of the state and tendency, as well as modifications, during a simulation program runtime without the necessity for their own expertise in efficient algorithms and data structures, high-performance computing, and visualisation. Nevertheless, when it comes to the real-time response of the simulation to this interaction − namely, keeping the connection between the user's change and its effect intuitive or at least observable − these environments are still limited in their possible application and, furthermore, often entail heavy code changes in order to be coupled to existing codes. Therefore, we introduce an integration framework applicable to different engineering applications, which with only minor code modifications involved supports distributed simulations as well as visualisation on-the-fly and enables real time interactive computational steering. Furthermore, we present its integration into a previously existing pre-operative planning environment for joint replacement surgery, which makes possible an interactive patient-specific selection of the optimal implant design, size, and position. The environment is supposed to enable the real-time surgeon's interplay with virtual models of bones and implants in 3D, thus, simultaneous computation and visualisation of the load transfer between the bone and the implant. Moreover, we tackle the problem of long communication delays which occur in the case of rigid coupling of simulation back-ends with visualisation front-ends and handicap a surgeon in observing which of his modifications leads to which outcome. Index Terms-Bone Mechanics, computational steering environment (cse), human femur, interactive computing, message passing interface (mpi).