The present work was aimed at clarifying the stress-shielding effect caused by hip-joint implantation into a femur by using a human cadaver with a cementless hip implant. In particular, bone quality was assessed from the standpoint of preferential c-axis orientation of biological apatite (BAp). Comparing the implanted side to the non-implanted side, a finite element analysis (FEA) indicated that artificial hip-joint implantation had a significant stress-shielding effect on the femur. The results also showed a marked decrease in the degree of preferential BAp orientation as well as bone loss in the medial-proximal femur. This is the first report showing a reduction in the degree of preferential BAp orientation due to a stress-shielding effect after artificial hip-joint implantation. Since preferential BAp orientation is an important index for determining bone mechanical function, these findings should be taken into account in future artificial hip-joint designs, especially those involving the stem component.
Background Internal fixation is recommended for treating Vancouver B1 periprosthetic femoral fractures. Although several fixation procedures have been developed with high fixation stability and union rates, long-term weight-bearing constructs are still lacking. Therefore, the aim of the present study was to evaluate the stability of a double-plate procedure using reversed contralateral locking compression-distal femoral plates for fixation of Vancouver B1 periprosthetic femoral fractures under full weight-bearing. Methods Single- and double-plate fixation procedures for locking compression-distal femoral plates were analysed under an axial load of 1,500 N by finite element analysis and biomechanical loading tests. A vertical loading test was performed to the prosthetic head, and the displacements and strains were calculated based on load-displacement and load-strain curves generated by the static compression tests. Results The finite element analysis revealed that double-plate fixation significantly reduced stress concentration at the lateral plate place on the fracture site. Under full weight-bearing, the maximum von Mises stress in the lateral plate was 268 MPa. On the other hand, the maximum stress in the single-plating method occurred at the defect level of the femur with a maximum stress value of 1,303 MPa. The principal strains of single- and double-plate fixation were 0.63 % and 0.058 %, respectively. Consistently, in the axial loading test, the strain values at a 1,500 N loading of the single- and double-plate fixation methods were 1,274.60 ± 11.53 and 317.33 ± 8.03 (× 10− 6), respectively. Conclusions The present study suggests that dual-plate fixation with reversed locking compression-distal femoral plates may be an excellent treatment procedure for patients with Vancouver B1 fractures, allowing for full weight-bearing in the early postoperative period.
Bone microstructure is dominantly composed of anisotropic extracellular matrix (ECM) in which collagen fibers and epitaxially-oriented biological apatite (BAp) crystals are preferentially aligned depending on the bone anatomical position, resulting in exerting appropriate mechanical function. The regenerative bone in bony defects is however produced without the preferential alignment of collagen fibers and the c-axis of BAp crystals, and subsequently reproduced to recover toward intact alignment. Thus, it is necessary to produce the anisotropic bone-mimetic tissue for the quick recovery of original bone tissue and the related mechanical ability in the early stage of bone regeneration. Our group is focusing on the methodology for regulating the arrangement of bone cells, the following secretion of collagen and the self-assembled mineralization by oriented BAp crystallites. Cyclic stretching in vitro to bone cells, principal-stress loading in vivo on scaffolds, step formation by slip traces on Ti single crystal, surface modification by laser induced periodic surface structure (LIPSS), anisotropic collagen substrate with the different degree of orientation, etc. can dominate bone cell arrangement and lead to the construction of the oriented ECM similar to the bone tissue architecture. This suggests that stress/strain loading, surface topography and chemical anisotropy are useful to produce bone-like microstructure in order to promote the regeneration of anisotropic bone tissue and to understand the controlling parameters for anisotropic osteogenesis induction.
The quantity and quality of regenerated bone strongly depends on the direction and amplitude of in vivo principal stress; therefore, in vivo stress distribution near bone implants should be optimized on the basis of the morphology of the interface between an implant and bone tissue. In this study, grooves were created on the implant surface in order to improve the surface morphology of the implant for optimizing in vivo stress distribution near the implant. The preferential alignment of the biological apatite (BAp) c-axis, which is a parameter of bone quality and controls the mechanical function of bones, is closely related to stress distribution; therefore, the direction of principal stress should be matched with the direction of the groove on the implant surface. Hip implants were prepared with grooves aligned at different angles from the surface; the grooves were located on the stem portion. These implants were inserted in a beagle femur to investigate the dependency of the quantity and quality of newly formed bone in the grooves on the groove angle. The degree of preferential alignment of the BAp c-axis of the regenerated bone in the grooves strongly depends on the angle of the groove to the principal stress vector that was estimated previously to an animal experiment. The regenerated bone forms anisotropic BAp orientation in response to the principal stress in the grooves; therefore, the direction of the grooves has to be designed on the basis of the stress distribution near the implant.
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