The influence of bone damage on press-fit mechanics

Bishop, Nick; Höhn, Jan-Christian; Rothstock, Stephan; Damm, Niklas B.; Morlock, Michael M.

doi:10.1016/j.jbiomech.2014.01.029

Cited by 34 publications

(50 citation statements)

References 23 publications

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“…Normal stresses of up to 10 MPa have been reported in the lateral cancellous bone using a 2D numerical model of a press-fit femoral stem (Kuiper and Huiskes, 1996). In the original study (Bishop et al, 2014) the most porous surface, with the highest friction coefficient (derived in the current study), was not found to result in the highest pull-out forces or radial forces, given a particular implantation force. This suggests that a higher friction coefficient does not necessarily translate to greater stability.…”

Section: Discussionmentioning

confidence: 52%

“…The experiment is described briefly in the following section. A detailed description can be found elsewhere (Bishop et al, 2014).…”

Section: Methodsmentioning

confidence: 99%

“…The friction coefficient ( Interface μ ) was determined for the entire push-in and pull-out process, from the raw axial and radial force data presented in Bishop et al (2014). The measured axial and radial force components ( F F , ,…”

Section: Friction Coefficient and Deformationmentioning

confidence: 99%

“…Implant surfaces have been shown to generate permanent trabecular bone deformation during simulated press-fit implantations (Bishop et al, 2014), leading to a press-fit interference that is less than the nominal interference between the implant and the cavity. This might explain the use of small interferences in modelling press-fit implantation to prevent unreasonably high stresses in the bone (Abdul-Kadir et al, 2008;Gebert et al, 2009;Rothstock et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Friction coefficient and effective interference at the implant-bone interface

Damm

Morlock

Bishop

2015

Journal of Biomechanics

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Section: Discussionmentioning

confidence: 52%

“…The experiment is described briefly in the following section. A detailed description can be found elsewhere (Bishop et al, 2014).…”

Section: Methodsmentioning

confidence: 99%

Section: Friction Coefficient and Deformationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Friction coefficient and effective interference at the implant-bone interface

Damm

Morlock

Bishop

2015

Journal of Biomechanics

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“…The radial contact stresses must be resisted by radial and circumferential stressing of the trabecular and cortical bone, which can consequently crush or fracture. It has been demonstrated that permanent deformation due to abrasion of medium quality trabecular bone during implantation, for a given pull‐out force, does not necessarily compromise press‐fit stability . However, a loss of effective interference has been documented and might reduce stability for a given nominal interference in position‐defined implantation.…”

mentioning

confidence: 99%

Influence of trabecular bone quality and implantation direction on press‐fit mechanics

Damm

Morlock

Bishop

2016

Journal Orthopaedic Research

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Achieving primary stability of uncemented press-fit prostheses in patients with poor quality bone can involve axial implantation forces large enough to cause bone fracture. Radial implantation eliminates intraoperative impaction forces and could prevent this damage. Platens of two commercial implant surfaces ("Beaded" and "Flaked") were implanted onto trabecular bone specimens of varying quality in a press-fit simulator. Samples were implanted with varying interference, either axially (shear) or radially (normal). Push-in and pull-out forces were measured to assess stability. Microstructural changes in the bone were determined from μCT analysis. For force-defined implantation analysis, push-in and pull-out forces both increased proportionally with increasing radial force, independent of implantation direction, bone quality or implant surface. For position-defined implantation analysis, pull-out forces were generally found to increase with interference and to be greater for radial than axial implantation direction, and to be lower for poor quality bone. Bone density increased locally at the tested interface due to implantation, in particular for the Beaded surface under axial implantation. If a safe radial stress can be determined for cortical bone in a particular patient, the associated implantation force, and pull-out force which represents primary stability, can be directly derived, regardless of implantation direction, bone quality or implant surface. Radial implantation delivers primary stability that is no worse than that for axial implantation and may eliminate potentially damaging impaction forces. Development of implant designs based on this principal might improve implant fixation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:224-233, 2017.

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Additive manufactured push‐fit implant fixation with screw‐strength pull out

Arkel

Ghouse

Milner

et al. 2017

Journal Orthopaedic Research

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Additive manufacturing offers exciting new possibilities for improving long‐term metallic implant fixation in bone through enabling open porous structures for bony ingrowth. The aim of this research was to investigate how the technology could also improve initial fixation, a precursor to successful long‐term fixation. A new barbed fixation mechanism, relying on flexible struts was proposed and manufactured as a push‐fit peg. The technology was optimized using a synthetic bone model and compared with conventional press‐fit peg controls tested over a range of interference fits. Optimum designs, achieving maximum pull‐out force, were subsequently tested in a cadaveric femoral condyle model. The barbed fixation surface provided more than double the pull‐out force for less than a third of the insertion force compared to the best performing conventional press‐fit peg (p < 0.001). Indeed, it provided screw‐strength pull out from a push‐fit device (1,124 ± 146 N). This step change in implant fixation potential offers new capabilities for low profile, minimally invasive implant design, while providing new options to simplify surgery, allowing for one‐piece push‐fit components with high levels of initial stability. © 2017 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:1508–1518, 2018.

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The influence of bone damage on press-fit mechanics

Cited by 34 publications

References 23 publications

Friction coefficient and effective interference at the implant-bone interface

Friction coefficient and effective interference at the implant-bone interface

Influence of trabecular bone quality and implantation direction on press‐fit mechanics

Additive manufactured push‐fit implant fixation with screw‐strength pull out

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