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Strain shielding for cemented hip implants.

Yekutiel Katz1, Zohar Yosibash1, Moshe Salai2

  • 1School of Mechanical Engineering, The Iby and Aladar Fleischman Faculty of Engineering, Tel-Aviv University, Ramat-Aviv, Israel.

Clinical Biomechanics (Bristol, Avon)
|May 25, 2020
PubMed
Summary
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Volumetric strain measurement effectively quantifies hip implant strain shielding, aiding surgeons in selecting patient-specific prostheses to reduce bone resorption and implant failure risks.

Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Computational Mechanics

Background:

  • Rising life expectancy necessitates improved long-term hip implant survival.
  • Strain shielding from implants can cause bone resorption, increasing risks of loosening and fractures.
  • Patient-specific strain shielding quantification can guide optimal prosthesis selection.

Purpose of the Study:

  • To develop and validate a systematic algorithm for quantifying strain shielding using CT-based finite element models.
  • To identify the most appropriate strain measure for assessing strain shielding.
  • To demonstrate patient-specific implant selection based on biomechanical analysis.

Main Methods:

  • Validated quantitative CT-based finite element models of five femurs (intact and implanted) were used.
Keywords:
Finite element analysisHip prosthesisStrain shielding

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  • Three strain measures (volumetric, von Mises, maximum principal) were investigated.
  • A systematic algorithm for strain shielding quantification was proposed and applied.
  • Main Results:

    • Volumetric strain measure showed better agreement with clinical bone resorption records and bone remodeling mechanisms compared to other measures.
    • The proposed algorithm, using volumetric strain, identified a collared implant design as preferable for a specific femur.
    • Similar strain shielding trends were observed across Gruen zones, with notable differences in zone 1.

    Conclusions:

    • Volumetric strain is recommended for strain shielding quantification due to its correlation with bone resorption.
    • The methodology enables patient-specific pre-operative strain shielding evaluation to minimize risks.
    • Further longitudinal studies are needed to correlate strain shielding predictions with clinical bone resorption outcomes.