Computational bone remodelling simulations and comparisons with DEXA results

Femoral periprosthetic bone loss following total hip replacement is often associated with stress shielding. Extensive bone resorption may lead to implant or bone failure and complicate revision surgery. In this study, an existing strain-adaptive bone remodelling theory was modified and combined with...

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Bibliographic Details
Published in:Journal of orthopaedic research 2005-07, Vol.23 (4), p.705-712
Main Authors: Turner, A.W.L., Gillies, R.M., Sekel, R., Morris, P., Bruce, W., Walsh, W.R.
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Adaptation, Physiological - physiology
Arthroplasty, Replacement, Hip
Bone Density - physiology
Bone mineral density
Bone Remodeling - physiology
Bone remodelling
Computer Simulation
Femur - diagnostic imaging
Femur - physiology
Femur - surgery
Finite element modelling
Hip arthroplasty
Humans
In Vitro Techniques
Models, Biological
Prosthesis Design
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Summary:Femoral periprosthetic bone loss following total hip replacement is often associated with stress shielding. Extensive bone resorption may lead to implant or bone failure and complicate revision surgery. In this study, an existing strain-adaptive bone remodelling theory was modified and combined with anatomic three-dimensional finite element models to predict alterations in periprosthetic apparent density. The theory incorporated an equivalent strain stimulus and joint and muscle forces from 45% of the gait cycle. Remodelling was simulated for three femoral components with different design philosophies: cobalt-chrome alloy, two-thirds proximally coated; titanium alloy, one-third proximally coated; and a composite of cobalt-chrome surrounded by polyaryletherketone, fully coated. Theoretical bone density changes correlated significantly with clinical densitometry measurements (DEXA) after 2 years across the Gruen zones ( R 2 > 0.67, p < 0.02), with average differences of less than 5.4%. The results suggest that a large proportion of adaptive bone remodelling changes seen clinically with these implants may be explained by a consistent theory incorporating a purely mechanical stimulus. This theory could be applied to pre-clinical testing of new implants, investigation of design modifications, and patient-specific implant selection.
ISSN:0736-0266
1554-527X
DOI:10.1016/j.orthres.2005.02.002