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

在无骨水泥全髋关节置换术中,植入物的长期稳定性是通过骨向内生长来实现的。由于骨骼的成熟和向内生长的进展,新键的强度随时间逐渐增加。在有限元模拟中,骨整合通常是作为植入物-骨界面的机械行为的即时变化来实现的,尽管这是对骨向内生长过程的简化解释。本研究的目的是在以前的骨向内生长模拟的基础上,提出一种新的方法来模拟骨向内生长,这是一个与时间有关的过程。我们开发了一种算法,可以根据界面微动的大小和时间间隙来计算局部植入物-骨键的强度。随后,我们的算法在多次髋关节重建中进行了测试,其中骨质量和植入物-骨接触面积发生了变化。模拟结果表明,在理想情况下 (良好的骨质量和无界面间隙),植入物区域的91% 可以实现向内生长,而在最坏的情况下,只有17% 的植入物区域显示向内生长。初始接触面积对向内生长有显着影响,从而推翻了骨质量变化的影响。向内生长的进程对相邻区域具有稳定作用,尤其是在高接触面积的情况下。提出的算法的进一步开发和验证需要更多有关向内生长速率与微动和间隙大小之间关系的性质的信息。

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