Influence of interface condition and implant design on bone remodelling and failure risk for the resurfaced femoral head

Rothstock, Stephan; Uhlenbrock, Anne Gebert de; Bishop, Nick; Laird, Lindsay; Nassutt, R.; Morlock, Michael M.

doi:10.1016/j.jbiomech.2011.02.076

Cited by 14 publications

(8 citation statements)

References 30 publications

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“…Similar effects with bone remodelling as well as femoral neck narrowing have been described for hip resurfacing arthroplasty (HRA), from which the CSRA design was originally derived . The causes for the bone resorption in HRA are still not completely understood and controversially discussed with bone necrosis, wear debris, and stress shielding being among the most frequently mentioned reasons .…”

Section: Discussionmentioning

confidence: 77%

“…Stress shielding has the strongest evidence to contribute to the bone remodelling processes in HRA . Several finite element analyses have identified the stem and the rim as primary route for load transfer , leading to distinct regional unloading of the bone under the femoral resurfacing component . The unloaded bone is then resorbed and has been described as femoral neck narrowing which is observed for a high percentage of the HRAs .…”

Section: Discussionmentioning

confidence: 99%

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Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Schmidutz

Sprecher

Milz

et al. 2015

Journal Orthopaedic Research

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Cementless-surface-replacement-arthroplasty (CSRA) of the shoulder aims for functional joint restoration with minimal bone loss. Good clinical results have been reported, but due to the radiopaque metal shell no data is available on the structure, osseous integration, and bone stock under the implant. 14 hemi-CSRAs (4 manufacturers) with two geometries (crown [n ¼ 7]/ stem [n ¼ 7] fixation) were retrieved from patients undergoing revision due to glenoidal erosion. Histological sections cutting through the implant centre and bone were analysed. Quantitative histomorphometry evaluated the bone-implant-contact and compared the bone-area to native humeral retrievals (n ¼ 7). The boneimplant-interface was further assessed by scanning-electron-microscopy (SEM) and energy-dispersive-x-ray (EDX). Qualitative histology revealed a reduced and inhomogeneous bone stock. Obvious signs of stress shielding were observed with bone predominantly visible at the stem and implant rim. Quantitative histomorphometry confirmed the significantly reduced bone-area (9.2 AE 3.9% [crown 9.9 AE 4.3%, stem 8.6 AE 3.6%]) compared to native humeri (21.2 AE 9.1%; p < 0.05). Bone-implant-contact was 20.5 AE 5.8% (crown 21.8 AE 6.2%, stem 19.2 AE 5.6%) which was confirmed by SEM and EDX. Altogether, CRSA shows satisfactory bone ingrowth at the interface suggesting sufficient primary stability to allow osseous integration. However, clear signs of stress shielding with an inhomogeneous and reduced bone stock were observed. The impact on the long-termresults is unclear requiring further investigation. ß

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Schmidutz

Sprecher

Milz

et al. 2015

Journal Orthopaedic Research

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“…However, with the aging population, the incidence of implant failure will be high in patients with severe alveolar bone absorption and/or poor bone quality [1][2][3][4] ; and, the waiting periods for prosthetic loading will take much longer. However, with the aging population, the incidence of implant failure will be high in patients with severe alveolar bone absorption and/or poor bone quality [1][2][3][4] ; and, the waiting periods for prosthetic loading will take much longer.…”

Section: Introductionmentioning

confidence: 99%

Bone integration capability of a series of strontium‐containing hydroxyapatite coatings formed by micro‐arc oxidation

Yan

Sun

Chu

et al. 2013

J Biomedical Materials Res

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Strontium-containing hydroxyapatites (Sr-HA) combine the desirable bone regenerative properties of hydroxyapatites (HA) with anabolic and anti-catabolic effects of strontium cations. In the present work, a series of Sr(y)HA [Sr(y)Ca(10-y)(PO4)6(OH)2; y = 0, 0.5, 1, 2] coatings on titanium are produced by micro-arc oxidation (MAO), and the effects of the in vivo osseointegration ability of the coatings are investigated by using a rabbit model. All samples are subjected to biomechanical, surface elemental, micro-CT and histological analysis after 4 and 12 weeks of healing. The obtained results show that the MAO-formed coatings exhibit a microporous network structure composed of Sr(y)HA/Sr(y)HA-Sr(x)Ca(1-x)TiO3/Sr(x)Ca(1-x)TiO3-TiO2 multilayers, in which the outer Sr(y)HA and intermediate Sr(y)HA-Sr(x)Ca(1-x)TiO3 layers have a nanocrystalline structure. All Sr-HA coated implants induce marked improvements in the behavior of bone formation, quantity and quality of bone tissue around the implants than the control HA implant and in particular, the 20%Sr-HA coating promotes early bone formation as identified by polyfluorochrome sequential labeling. The bone-to-implant contact is increased by 46% (p< 0.05) and the pull-out strength is increased by 103% over the HA group (p < 0.01). Extensive areas of mineralized tissue densely deposit on the 20%Sr-HA coating after biomechanical testing, and the greatest improvement of bone microarchitecture are observed around the 20%Sr-HA implant. The identified biological parameters successfully demonstrate the osteoconductivity of 20%Sr-HA surfaces, which results not only in an acceleration but also an improvement of bone-implant integration. The study demonstrates the immense potential of 20%Sr-HA coatings in dental and orthopedic applications.

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“…It is an inexpensive method that can be used to extensively analyse an implant and study the effects of diverse parameters such as implant positioning, implant fixation type (unfixed, cemented) or cement mantle thickness Taylor, 2007a, 2007b;Rothstock et al, 2011). It is particularly useful for the investigation of new and experimental implants (Dickinson et al, 2010;Harrysson et al, 2007;Heijink et al, 2008;Ong et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Influence of the stem fixation scenario on load transfer in a hip resurfacing arthroplasty with a biomimetic stem

Caouette

Bureau

Vendittoli

et al. 2015

Journal of the Mechanical Behavior of Biomedical Materials

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Influence of interface condition and implant design on bone remodelling and failure risk for the resurfaced femoral head

Cited by 14 publications

References 30 publications

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant

Bone integration capability of a series of strontium‐containing hydroxyapatite coatings formed by micro‐arc oxidation

Influence of the stem fixation scenario on load transfer in a hip resurfacing arthroplasty with a biomimetic stem

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