The effects of pylon shape on bone–pylon interface performance in direct skeletal attachment

Abstract

The attachment of a prosthesis directly to the part of the skeleton remaining after an amputation offers many improvements over coupling schemes used in conventional prostheses. However, the stresses induced in the bone by the macrostructure of the attached prosthetic device must first be understood because they are a significant consideration in the design of a successful direct skeletal attachment (DSA) system. This investigation utilizes the finite element method of analysis to structurally model some possible DSA systems. Static stress-response models for an above-the-knee human femoral amputation are formulated to investigate the effect of variations in pylon macrostructure on system performance. The models approximate the initial stages of support following the insertion of a pylon into the medullary cavity of the bone and are also used to assess the bond strengths that must be developed between the bone and pylon for a "no-slip" condition to hold at their interface. The analyses indicate that either a shaped, marrow cavity-fit pylon or four 135 degree wedges with a complementary pylon are favorable geometries for a DSA system. The stress levels caused by these two geometries are on the order of 20% of the axial compressive strength of cortical bone. For each, local stress levels at the bone-biomaterial interface remain the critical parameters for investigation.