Bone remodelling inside a cemented resurfaced femoral head

Gupta, Sanjay; New, A.M.R.; Taylor, Mark

doi:10.1016/j.clinbiomech.2006.01.010

Cited by 75 publications

(85 citation statements)

References 20 publications

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“…A mechanostat principle was applied, based upon the strain history stimulus required to produce a bone volume change (Carter 1984), and implemented using Euler forward integration to calculate iterative changes in the thickness of cortex elements (external remodelling), or the heterogeneous density-and hence the Young's modulus-of trabecular elements (internal remodelling). This method has been applied to femoral implants in THR (Kerner et al 1999;Turner et al 2005), RHR (Gupta et al 2006;Pal et al 2009;Rothstock et al 2011;Dickinson et al 2012;Perez et al 2014), to acetabular cups (Ghosh et al 2013), and in other joints (van Lenthe et al 1997). Advanced approaches have combined strain adaptive bone remodelling with other associated mechanobiological processes, including cementless implant ingrowth (Tarala et al 2011) and periprosthetic defect healing (Dickinson et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Dickinson

2015

Biomech Model Mechanobiol

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Bone morphology and density changes are commonly observed following joint replacement, and may contribute to the risks of implant loosening and periprosthetic fracture, and reduce the available bone stock for revision surgery. This study was presented in the "Bone and Cartilage Mechanobiology across the scales" WCCM symposium to review the development of remodelling prediction methods and to demonstrate simulation of adaptive bone remodelling around hip replacement femoral components, incorporating intrinsic (prosthesis) and extrinsic (activity and loading) factors.An iterative bone remodelling process was applied to finite element models of a femur implanted with a cementless THR (total hip replacement) and a hip resurfacing implant. Previously developed for a cemented THR implant, this modified process enabled the influence of pre-to postoperative changes in patient activity and joint loading to be evaluated. A control algorithm used identical pre-and postoperative conditions, and the predicted extents and temporal trends of remodelling were measured by generating virtual x-rays and DXA scans.The modified process improved qualitative and quantitative remodelling predictions for both the cementless THR and resurfacing implants, but demonstrated the sensitivity to DXA scan region definition and appropriate implant-bone position and sizing. Predicted remodelling in the intact femur in response to changed activity and loading demonstrated that in this simplified model, although the influence of the extrinsic effects were important, the mechanics of implantation were dominant. This study supports the application of predictive bone remodelling as one element in the range of physical and computational studies, which should be conducted in the pre-clinical evaluation of new prostheses.

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Section: Introductionmentioning

confidence: 99%

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Dickinson

2015

Biomech Model Mechanobiol

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“…Bone adaptation and remodelling: Bone remodelling simulations have been performed extensively, primarily to assess stress shielding around the femoral component of hip arthroplasty (Perez et al, 2010;Taylor et al, 2004;Weinans et al, 1994;Gupta et al, 2006;Huiskes et al, 1992;Weinans et al, 1992Weinans et al, , 1993Stulpner et al, 1997;Folgado et al, 2009;Pal and Gupta 2011;Shim et al, 2012). Since the publication of the first bone remodelling simulations around implants by Huiskes and co-workers (Huiskes, 1988), there have only been incremental developments, for example accounting for overload induced bone loss (Behrens et al, 2009;Scannell and Prendergast, 2009).…”

Section: Time Dependent/adaptive Modelling Techniquesmentioning

confidence: 99%

“…The main focus of this review will be hip and knee replacement, as these have been studied the most, but the issues raised are applicable to the simulation of all orthopaedic devices. FE models have grown in both size and sophistication and techniques exist to assess the initial post-op mechanical environment Zivkovic et al, 2010;Chong et al, 2010;Pettersen et al, 2009;Reggiani et al, 2008;Udofia et al, 2007;Spears et al, 2001;Baldwin et al, 2008;Godest et al, 2002;Taylor and Barrett 2003;Perillo-Marcone and Taylor 2007;Chang et al, 2001) through to the simulation of time dependent processes including bone remodelling induced stress shielding (Huiskes et al, 1987;Perez et al, 2010;Behrens et al, 2009;Gillies et al, 2007;Taylor et al, 2004;McNamara et al, 1997;Weinans et al, 1994;Rietbergen et al, 1993;Gupta et al, 2006), tissue adaptation Andreykiv et al, 2005;Simmons et al, 2001), wear (Strickland et al, 2011;Strickland and Taylor 2009;Knight et al, 2007;Fregly et al, 2005;Bevill et al, 2005;Teoh et al, 2002;Brown et al, 2002;Maxian et al, 1996;Pal et al, 2008), damage accumulation of the cement mantle (Coultrup et al, 2010;Janssen et al, 2009;Lennon et al, 2007;Jeffers et al, 2007;Janssen et al, 2006;…”

Section: Introductionmentioning

confidence: 99%

Four decades of finite element analysis of orthopaedic devices: Where are we now and what are the opportunities?

Taylor

Prendergast

2015

Journal of Biomechanics

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140

106

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a b s t r a c tFinite element has been used for more than four decades to study and evaluate the mechanical behaviour total joint replacements. In Huiskes seminal paper "Failed innovation in total hip replacement: diagnosis and proposals for a cure", finite element modelling was one of the potential cures to avoid poorly performing designs reaching the market place. The size and sophistication of models has increased significantly since that paper and a range of techniques are available from predicting the initial mechanical environment through to advanced adaptive simulations including bone adaptation, tissue differentiation, damage accumulation and wear. However, are we any closer to FE becoming an effective screening tool for new devices? This review contains a critical analysis of currently available finite element modelling techniques including (i) development of the basic model, the application of appropriate material properties, loading and boundary conditions, (ii) describing the initial mechanical environment of the bone-implant system, (iii) capturing the time dependent behaviour in adaptive simulations, (iv) the design and implementation of computer based experiments and (v) determining suitable performance metrics.The development of the underlying tools and techniques appears to have plateaued and further advances appear to be limited either by a lack of data to populate the models or the need to better understand the fundamentals of the mechanical and biological processes. There has been progress in the design of computer based experiments. Historically, FE has been used in a similar way to in vitro tests, by running only a limited set of analyses, typically of a single bone segment or joint under idealised conditions. The power of finite element is the ability to run multiple simulations and explore the performance of a device under a variety of conditions. There has been increasing usage of design of experiments, probabilistic techniques and more recently population based modelling to account for patient and surgical variability. In order to have effective screening methods, we need to continue to develop these approaches to examine the behaviour and performance of total joint replacements and benchmark them for devices with known clinical performance.Finite element will increasingly be used in the design, development and pre-clinical testing of total joint replacements. However, simulations must include holistic, closely corroborated, multi-domain analyses which account for real world variability.

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“…Bone mass is regulated by elastic strain energy per unit mass, and when the difference between the treated bone and untreated bone reaches a certain threshold, no remodeling takes place and the model converges. More recently, Gupta et al [43] uses this adaptive bone remodeling theory to assess the short term risk of femoral neck fracture (1-2 years) and long term risk of failure of fixation (5 years) of a cemented resurfacing femoral head. Results showed strain shielding in the femoral head with a 50-90% reduction in bone density in the superior femoral head region and elevated strains of 0.50 -0.80% generated in the superior femoral neck.…”

Section: Previous Remodeling Simulationsmentioning

confidence: 99%

“…Previously, studies have been performed to examine postoperative changes in femoral bone density to evaluate effects of different muscle groups on the remodeling process as well as changes following hip arthroplasty [43,54,55]. Deuel improved the current three-dimensional femur models by implementing the remodeling algorithm by Hazelwood et al in order to incorporate the biological mechanism of remodeling to study changes in bone density following total hip and hip resurfacing arthroplasty procedures.…”

Section: Finite Element Analysis Modelingmentioning

confidence: 99%

Modeling the Long Term Effects of Alendronate on Bone Mass Preservation of the Femur with Articular Surface and Total Hip Replacements

Hryce¹

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Bone remodelling inside a cemented resurfaced femoral head

Cited by 75 publications

References 20 publications

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Four decades of finite element analysis of orthopaedic devices: Where are we now and what are the opportunities?

Modeling the Long Term Effects of Alendronate on Bone Mass Preservation of the Femur with Articular Surface and Total Hip Replacements

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