Prediction of Bone Mineral Density (BMD) Adaptation in Pelvis-Femur Model with Hip Arthroplasties

The prediction of bone remodeling behaviour is a challenging factor in encouraging the long-term stability of hip arthroplasties. The presence of femoral components modifies the biomechanical environment of the bone and alters the bone growth process. Issues of bone loss and gait instability on both limbs are associated with the remodeling process. In this study, finite element analysis with an adaptive bone remodeling algorithm was used to predict the changes in bone mineral density following total hip and resurfacing hip arthroplasty. A three-dimensional model of the pelvis-femur was constructed from computed tomography (CT-based) images of a 79-year-old female patient with hip osteoarthritis. The prosthesis stem of the total hip arthroplasty was modelled with a titanium alloy material, while the femoral head had alumina properties. Meanwhile, resurfacing of the hip implant was completed with a cobalt-chromium material. Contact between the components and bone was designed to be perfectly bonded at the interface. Results indicate that the bone mineral density was modified over five years on all models, including hip osteoarthritis. The changes of BMD were predicted as being high between year zero and year one, especially in the proximal region. Changes were observed to be minimal in the following years. The bone remodeling process was also predicted for the non-operated femur. However, the adaptation was lower compared to the operated limbs. The reduction in bone mineral density suggested the bone loss phenomenon after a few years.