Efficient computational method for assessing the effects of implant positioning in cementless total hip replacements

Bah, Mamadou; Nair, Prasanth B.; Taylor, Mark; Browne, Martin

doi:10.1016/j.jbiomech.2010.12.027

Cited by 48 publications

(32 citation statements)

References 24 publications

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“…Excessive bone-implant relative micromovements can compromise this stability (Pillar et al, 1986;Engh et al 1992;Soballe et al, 1993). These micromovements depend on implant design and positioning (Howard et al, 2004;Paratte et al, 2007;Andreaus et al, 2008;Park et al, 2009;Dopico-González et al, 2010;Reggiani et al, 2008;Bah et al, 2011;Reimeringer et al, 2012), possible interfacial gaps and the magnitude of forces acting on the proximal femur and patient anatomy (Pancanti et al, 2003). Therefore, when introducing new stem designs, it is essential that rigorous preclinical testing is conducted, both computationally and physically, since clinical problems associated with new designs may not be evident for some time.…”

Section: Introductionmentioning

confidence: 99%

Inter-subject variability effects on the primary stability of a short cementless femoral stem

Bah

Shi

Heller

et al. 2015

Journal of Biomechanics

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TITLEInter-subject variability effects on the primary stability of a short cementless femoral stem AUTHORSBah, Mamadou T.; Shi, Junfen; Heller, Markus O.; et al. JOURNAL Journal of Biomechanics DEPOSITED IN ORE July 2015This version available at http://hdl.handle.net/10871/17901 COPYRIGHT AND REUSEOpen Research Exeter makes this work available in accordance with publisher policies. A NOTE ON VERSIONSThe version presented here may differ from the published version. If citing, you are advised to consult the published version for pagination, volume/issue and date of publication This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. demonstrates that the primary stability and tolerance of the short stem to variability in patient anatomy were high, reducing the need for patient stratification. In addition, the developed tool could be utilised to support implant design and planning of femoral reconstructive surgery.

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Section: Introductionmentioning

confidence: 99%

Inter-subject variability effects on the primary stability of a short cementless femoral stem

Bah

Shi

Heller

et al. 2015

Journal of Biomechanics

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“…Of greater importance might be the consideration of patient specific hip contact and muscle forces, and their pre-to postoperative changes (Jonkers et al 2008). With sufficient input data, multi-patient analysis using this method could be achieved with relatively low computational expense by modifying this verified mesh by freeform deformation (Fernandez et al 2013), and employing mesh morphing to incorporate the effects of surgical variability (Bah et al 2011) and implant sizing.…”

Section: Discussionmentioning

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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“…Cementless components rely, in part, on an interference fit to achieve the necessary level of primary stability, and our knowledge of how the interference fit is developed through the interactions between the bone and the implant is poorly understood. The majority of studies of the implant proximal femur (Reggiani et al, 2008;Bah et al, 2011) and proximal tibial Chong et al, 2010) assume no interference at the bone implant interface. If an interference fit is simulated, how much should be included and how to simulate it?…”

Section: Simulation Of the Initial Mechanical Environment Of The Bonementioning

confidence: 99%

“…Most studies assume that the supporting bone is linear elastic (Chong et al, 2010;Reggiani et al, 2008;Abdul-Kadir et al, 2008;Bah et al, 2011), despite some studies reporting stresses that approach or exceed the yield stress (Taylor et al, 1995;Kelly et al, 2013;Rohlmann et al, 1988;Ong et al, 2006;Hothi et al, 2011;Rothstock et al, 2010). In addition, the viscoelastic properties will lead to stress relaxation, particularly if an interference fit is simulated.…”

Section: Simulation Of the Initial Mechanical Environment Of The Bonementioning

confidence: 99%

“…The Monte Carlo approach suffers from the curse of dimensionality, with the number of deterministic analyses needed increasing exponentially with the addition of more parameters. The number of analyses needed can be reduced through sampling methods (Dopico-Gonzalez et al, 2009), implementing reliability methods (Pal et al, 2008;Laz et al, 2006a,b) and the additional use of surrogate modellling (Bah et al, 2011) to minimise the computational cost. The challenge in developing and implementing probabilistic techniques is automating the simulation process, particularly when aiming to generate hundreds or thousands of models to explore the effects implant alignment or patient to patient variability.…”

Section: Design Of Computer Based Experimentsmentioning

confidence: 99%

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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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139

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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Efficient computational method for assessing the effects of implant positioning in cementless total hip replacements

Cited by 48 publications

References 24 publications

Inter-subject variability effects on the primary stability of a short cementless femoral stem

Inter-subject variability effects on the primary stability of a short cementless femoral stem

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?

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