Adaptive bone remodeling and biomechanical design considerations: for noncemented thtal ffip arthroplasty

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Huiskes, Rik¹; Weinans, Harrie¹; Dalstra, Michel¹

Adaptive bone remodeling and biomechanical design considerations: for noncemented thtal ffip arthroplasty

Orthopedics. September 1989;12(9):1255-1267

Affiliations

¹Biomechanics Section, Institute of Orthopedics, University of Nijmegen, The Netherlands
Abstract

Clinical problems with noncemented total hip arthroplasty (THA) stems, directly or indirectly related to load transfer, include mid-thigh pain due to relative (micro) motions or excessive endosteal interface stresses, subsidence and loosening due to inadequate primary stability and fit, and proximal femoral bone atrophy due to stress shielding. In this article, the load-transfer mechanisms associated with noncemented THA stems and their resulting stress patterns are discussed in relation to design features, bonding characteristics, and materials choice. Nonlinear finite-element models and computer simulation programs for strain-adaptive bone remodeling have been used for this study. Canal-filling, fully bonded metal stems have been found likely to cause proximal bone atrophy, possibly leading to long-term failure of the implant/bone composite. The use of flexible (isoelastic) materials and/or press-fit fixation reduces stress shielding, but also reduces the potential for interface stability. The stem material, the stem shape, and the coating geometry interact in relation to the load-transfer mechanism, and it is suggested that optimal combinations of these characteristics can be determined through the computer simulation methods presented.
Links

PubMed: 2798252

WoS: A1989AQ30700011

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Cited By (25)

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1996	van Rietbergen B. Mechanical Behavior and Adaptation of Trabecular Bone in Relation to Bone Morphology [PhD thesis]. Nijmegen, Netherlands: Catholic University of Nijmegen; 1996.
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1990	Huiskes R. The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res. December 1990;261:27-38.
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1992	Weinans H, Huiskes R, Grootenboer HJ. The behavior of adaptive bone-remodeling simulation models. J Biomech. December 1992;25(12):1425-1441.
1993	Van Rietbergen B, Huiskes R, Weinans H, Sumner DR, Turner TM, Galante JO. The mechanism of bone remodeling and resorption around press-fitted THA stems. J Biomech. April–May 1993;26(4-5):369-382.
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