Stair climbing is more critical than walking in pre-clinical assessment of primary stability in cementless THA in vitro

Kassi, Jean-Pierre; Heller, Markus O.; Stoeckle, Ulrich; Perka, Carsten; Duda, Georg N.

doi:10.1016/j.jbiomech.2004.05.023

Cited by 85 publications

(94 citation statements)

References 48 publications

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“…We found higher micromotion in torsion (stair climbing) than in compression (walking). This result compares well with results from Enoksen et al (2014) and Kassi et al (2005) obtained with LVDTs or with measurements from postmortem retrieval sections by Mann et al (2012). The patterns of micromotion revealed that for axial compression, micromotion was low proximally and high distally.…”

Section: Discussionsupporting

confidence: 87%

“…In torsion, we found high micromotion proximally and lower micromotion distally. Kassi et al (2005) and Pancanti et al (2003) also measured higher micromotion proximally but they had a second region of high micromotion at the tip of the stem. Differences in loading and constraints can be possible explanations for this variation.…”

Section: Discussionmentioning

confidence: 93%

“…This value encompasses random errors due to the precision of loading, to the transmission of load to the femoral stem, and to the viscoelastic behavior of bone. It can be compared to similar measures of repeatability performed for LVDTs setups: Monti et al (1999) obtained a maximum value of 5 mm for intra-specimen standard deviation, Viceconti et al (2000) measured a maximum intra-specimen variability of 9 mm, while Kassi et al (2005) and Østbyhaug et al (2010) got values of 3 mm and 1.65 mm respectively for repeatability standard deviation. The repeatability of micro-CT based micromotion measurement is thus similar to the repeatability of LVDTbased micromotion measurement.…”

Section: Discussionmentioning

confidence: 96%

“…Considering the maximum micromotion still allowing osseointegration is around 100 mm, this bias value would represent a relative error of 10%. Current techniques available to measure implant micromotion rely mostly on linear variable differential transformers (LVDTs) (Enoksen et al, 2014;Fottner et al, 2009;Kassi et al, 2005;Monti et al, 1999;Pettersen et al, 2009;Østbyhaug et al, Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jbiomech www.JBiomech.com 2010). Despite their excellent accuracy, they allow only a handful of simultaneous measurement points.…”

Section: Introductionmentioning

confidence: 99%

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Full-field measurement of micromotion around a cementless femoral stem using micro-CT imaging and radiopaque markers

Camine

Rüdiger

Pioletti

et al. 2016

Journal of Biomechanics

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a b s t r a c tA good primary stability of cementless femoral stems is essential for the long-term success of total hip arthroplasty. Experimental measurement of implant micromotion with linear variable differential transformers is commonly used to assess implant primary stability in pre-clinical testing. But these measurements are often limited to a few distinct points at the interface. New techniques based on microcomputed tomography (micro-CT) have recently been introduced, such as Digital Volume Correlation (DVC) or markers-based approaches. DVC is however limited to measurement around non-metallic implants due to metal-induced imaging artifacts, and markers-based techniques are confined to a small portion of the implant. In this paper, we present a technique based on micro-CT imaging and radiopaque markers to provide the first full-field micromotion measurement at the entire bone-implant interface of a cementless femoral stem implanted in a cadaveric femur. Micromotion was measured during compression and torsion. Over 300 simultaneous measurement points were obtained. Micromotion amplitude ranged from 0 to 24 mm in compression and from 0 to 49 mm in torsion. Peak micromotion was distal in compression and proximal in torsion. The technique bias was 5.1 mm and its repeatability standard deviation was 4 mm. The method was thus highly reliable and compared well with results obtained with linear variable differential transformers (LVDTs) reported in the literature. These results indicate that this micro-CT based technique is perfectly relevant to observe local variations in primary stability around metallic implants. Possible applications include pre-clinical testing of implants and validation of patient-specific models for pre-operative planning.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Full-field measurement of micromotion around a cementless femoral stem using micro-CT imaging and radiopaque markers

Camine

Rüdiger

Pioletti

et al. 2016

Journal of Biomechanics

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show abstract

“…The stem designs were compared using stair-climbing loading condition which is considered to be more critical than walking for THR stability studies [22]. Weight bearing and muscle forces are patient weight dependent and were proportionalized from Table 1 (average patient body weight of 750 N [23]).…”

Section: Loading and Boundary Conditionsmentioning

confidence: 99%

Development and Verification of a Cementless Novel Tapered Wedge Stem for Total Hip Arthroplasty

Faizan

Wuestemann

Nevelos

et al. 2015

The Journal of Arthroplasty

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The influence of loading configurations on numerical evaluation of failure mechanisms in an uncemented femoral prosthesis

Mathai

Gupta

2020

Numer Methods Biomed Eng

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The clinical relevance of numerical predictions of failure mechanisms in femoral prosthesis could be impaired due to simplification of musculoskeletal loading. This study investigated the extent to which loading configurations affect the preclinical analysis of an uncemented femoral implant. Patient‐specific, CT‐scan based FE models of intact and implanted femurs were developed and analysed using three loading configurations, which comprised of load cases representing daily activities. First loading configuration consisted of two load cases, each of walking and stair climbing. The second consisted of more number of load cases for each of these activities. The third included load cases of additional activities of standing up and sitting down. Failure criteria included maximum principal strains, interface debonding, implant‐bone relative displacement and adaptive bone remodelling. Simplified loading configurations led to a reduction (100‐1500 με) around cortical principal strains. The area prone to interface debonding were observed in the proximo‐medial part of implant and was maximum when all activities were considered. This area was reduced by 35%, when simplified loading configurations were chosen. Interfacial area of 88%‐96% experienced implant‐bone relative displacements below 40 μm; however maximum of 110 μm was observed at the calcar region. Lack of consideration of variety of activities overestimated (30%‐50%) bone resorption around the lateral part of the implant; hence, these bone remodelling results were less clinically relevant. Considering a variety daily activities along with an adequate number of load cases for each activity seemed necessary for pre‐clinical evaluations of reconstructed femur.

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Stair climbing is more critical than walking in pre-clinical assessment of primary stability in cementless THA in vitro

Cited by 85 publications

References 48 publications

Full-field measurement of micromotion around a cementless femoral stem using micro-CT imaging and radiopaque markers

Full-field measurement of micromotion around a cementless femoral stem using micro-CT imaging and radiopaque markers

Development and Verification of a Cementless Novel Tapered Wedge Stem for Total Hip Arthroplasty

The influence of loading configurations on numerical evaluation of failure mechanisms in an uncemented femoral prosthesis

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