Ossäre Strukturveränderungen periprothetischer Knochenanteile nach Versorgung mittels Endo-Exo-Prothesensystemen (EEP) nach Oberschenkelamputation

Örgel, Marcus; Liodakis, E; Omar, Mohammed A.; Jaratjitwilai, Pratya; Harb, Afif; Wirries, N; Krettek, C.; Aschoff, H-H

doi:10.1055/s-0040-1717467

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mechanical stability of osseointegrated implants is granted by the ingrowth of bone tissue in the porosities of the implant surface. Despite the clinical advantages of the osseointegrated transfemoral prostheses, failure does occur due to septic or aseptic causes with an incidence between 3% and 30% (Juhnke et al, 2015;Aschoff and Juhnke, 2016;Hagberg et al, 2020;Muderis and Glatt, 2016;Leijendekkers et al, 2017;Atallah et al, 2018;Hansen et al, 2019;Ranker et al, 2020;Reetz et al, 2020;Örgel et al, 2020). Septic complications mainly derive from soft tissue infection at the stoma.…”

Section: Introductionmentioning

confidence: 99%

Reliable in vitro method for the evaluation of the primary stability and load transfer of transfemoral prostheses for osseointegrated implantation

Galteri,

Palanca,

Alesi

et al. 2024

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Osseointegrated transfemoral prostheses experience aseptic complications with an incidence between 3% and 30%. The main aseptic risks are implant loosening, adverse bone remodeling, and post-operative periprosthetic fractures. Implant loosening can either be due to a lack of initial (primary) stability of the implant, which hinders bone ingrowth and therefore prevents secondary stability, or, in the long-term, to the progressive resorption of the periprosthetic bone. Post-operative periprosthetic fractures are most often caused by stress concentrations. A method to simultaneously evaluate the primary stability and the load transfer is currently missing. Furthermore, the measurement errors are seldom reported in the literature. In this study a method to reliably quantify the bone implant interaction of osseointegrated transfemoral prostheses in terms of primary stability and load transfer was developed, and its precision was quantified. Micromotions between the prosthesis and the host bone and the strains on the cortical bone were measured on five human cadaveric femurs with a typical commercial osseointegrated implant. To detect the primary stability of the implant and the load transfer, cyclic loads were applied, simulating the peak load during gait. Digital Image Correlation was used to measure displacements and bone strains simultaneously throughout the test. Permanent migrations and inducible micromotions were measured (three translations and three rotations), while, on the same specimen, the full-field strain distribution on the bone surface was measured. The repeatability tests showed that the devised method had an intra-specimen variability smaller than 6 μm for the translation, 0.02 degrees for the rotations, and smaller than 60 microstrain for the strain distribution. The inter-specimen variability was larger than the intra-specimen variability due to the natural differences between femurs. Altogether, the measurement uncertainties (intrinsic measurement errors, intra-specimen repeatability and inter-specimen variability) were smaller than critical levels of biomarkers for adverse remodelling and aseptic loosening, thus allowing to discriminate between stable and unstable implants, and to detect critical strain magnitudes in the host bone. In conclusion, this work showed that it is possible to measure the primary stability and the load transfer of an osseointegrated transfemoral prosthesis in a reliable way using a combination of mechanical testing and DIC.

show abstract