TY - JOUR
T1 - Improving peri-prosthetic bone adaptation around cementless hip stems
T2 - a clinical and finite element study
AU - ten Broeke, René H.M.
AU - Tarala, Maria
AU - Arts, Jacobus J.C.
AU - Janssen, Dennis W.
AU - Verdonschot, Nico
AU - Geesink, Rudolph G.T.
PY - 2014/3
Y1 - 2014/3
N2 - This study assessed whether the Symax™ implant, a modification of the Omnifit® stem (in terms of shape, proximal coating and distal surface treatment), would yield improved bone remodelling in a clinical DEXA study, and if these results could be predicted in a finite element (FE) simulation study.In a randomized clinical trial, 2 year DEXA measurements between the uncemented Symax™ and Omnifit® stem (both n=25) showed bone mineral density (BMD) loss in Gruen zone 7 of 14% and 20%, respectively (p<0.05). In contrast, the FE models predicted a 28% (Symax™) and 26% (Omnifit®) bone loss. When the distal treatment to the Symax™ was not modelled in the simulation, bone loss of 35% was predicted, suggesting the benefit of this surface treatment for proximal bone maintenance.The theoretical concept for enhanced proximal bone loading by the Symax™, and the predicted remodelling pattern were confirmed by DEXA-results, but there was no quantitative match between clinical and FE findings. This was due to a simulation based on incomplete assumptions concerning the yet unknown biological and mechanical effects of the new coating and surface treatment.
AB - This study assessed whether the Symax™ implant, a modification of the Omnifit® stem (in terms of shape, proximal coating and distal surface treatment), would yield improved bone remodelling in a clinical DEXA study, and if these results could be predicted in a finite element (FE) simulation study.In a randomized clinical trial, 2 year DEXA measurements between the uncemented Symax™ and Omnifit® stem (both n=25) showed bone mineral density (BMD) loss in Gruen zone 7 of 14% and 20%, respectively (p<0.05). In contrast, the FE models predicted a 28% (Symax™) and 26% (Omnifit®) bone loss. When the distal treatment to the Symax™ was not modelled in the simulation, bone loss of 35% was predicted, suggesting the benefit of this surface treatment for proximal bone maintenance.The theoretical concept for enhanced proximal bone loading by the Symax™, and the predicted remodelling pattern were confirmed by DEXA-results, but there was no quantitative match between clinical and FE findings. This was due to a simulation based on incomplete assumptions concerning the yet unknown biological and mechanical effects of the new coating and surface treatment.
KW - Bone mineral density
KW - Cementless hip arthroplasty
KW - DEXA
KW - Finite element analysis
UR - http://www.scopus.com/inward/record.url?scp=84895920297&partnerID=8YFLogxK
U2 - 10.1016/j.medengphy.2013.12.006
DO - 10.1016/j.medengphy.2013.12.006
M3 - Article
C2 - 24378381
AN - SCOPUS:84895920297
VL - 36
SP - 345
EP - 353
JO - Medical Engineering & Physics
JF - Medical Engineering & Physics
SN - 1350-4533
IS - 3
ER -