In cementless total hip arthroplasty, long-term implant stability is achieved by bone ingrowth. The strength of the new bond gradually increases in time, due to bone maturation and progression of ingrowth. In finite element simulations, osseointegration generally is implemented as an instant change in the mechanical behavior of the implant-bone interface, although this is a simplified interpretation of the bone ingrowth process. The aim of the present study was to build on previous bone ingrowth simulations and propose a new methodology to simulate bone ingrowth as a time-dependent process. We developed an algorithm to calculate the strength of the local implant-bone bond based of the magnitude of interface micromotions and gaps in time. Our algorithm was subsequently tested in multiple hip reconstructions in which the bone quality and implant-bone contact area were varied. The results of the simulations showed that in the ideal situation (good bone quality and no interface gaps), 91% of implant area could achieve ingrowth, while in the worst case only 17% of implant area showed ingrowth. The initial contact area had a significant effect on ingrowth, overruling the effect of variations in bone quality. The progression of ingrowth had a stabilizing effect on adjacent regions, especially in the high contact area cases. Further development and validation of the presented algorithm requires more information on the nature of the relation between the ingrowth rate and the magnitude of micromotions and gap.

译文

:在非骨水泥全髋关节置换术中,骨向内生长可实现长期的植入物稳定性。由于骨骼成熟和向内生长,新结合的强度会随着时间逐渐增加。在有限元模拟中,骨整合通常是植入物-骨界面机械行为的即时变化,尽管这是对骨长入过程的简化解释。本研究的目的是在以前的骨骼长入模拟的基础上,提出一种新的方法来模拟骨骼长入作为一个与时间有关的过程。我们开发了一种算法,可以根据界面微运动的大小和时间间隔来计算局部植入物-骨结合的强度。我们的算法随后在多种髋关节重建术中进行了测试,在这些重建术中,骨骼质量和植入物与骨的接触面积均发生了变化。模拟结果表明,在理想情况下(良好的骨骼质量和无界面间隙),植入物面积的91%可以实现向内生长,而在最坏的情况下,只有17%的植入物区域可以向内生长。最初的接触面积对内生长有显着影响,但不影响骨质变化的影响。向内生长对邻近区域具有稳定作用,尤其是在高接触面​​积的情况下。所提出算法的进一步开发和验证需要关于长入率与微动和间隙大小之间关系的性质的更多信息。

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