The presence of a femoral hip stem changes local mechanical signals inside the surrounding bone. In this study we examined the hypothesis that the eventual loss of bone can be estimated from the initial patterns of elastic energy deviation, as determined in FE models of the intact bone and the operated femur. For that purpose two hypothetical relations between elastic energy reduction and resorption were investigated. Their estimates of bone loss were compared to the results of iterative computer simulations. Two kinds of FE model were used, and in each stem stiffness and remodeling threshold (a measure of “biological reactivity”) were varied. Provided that reasonable values of the remodeling threshold are assumed and that the stem is firmly bonded to the bone, we found that the difference between direct estimates and simulation models was 4 percent of bone loss. It is therefore concluded that initial patterns of elastic energy deviation give a reasonable indication of expected bone loss.

1.
Bobyn
J. D.
,
Mortimer
E. S.
,
Glassman
A. H.
,
Engh
C. A.
,
Miller
J. E.
, and
Brooks
C. E.
,
1992
, “
Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip arthroplasty
,”
Clin. Orthop. Rel. Res.
, Vol.
274
, pp.
79
96
.
2.
Carter
D. R.
,
1982
, “
The relationships between in vivo bone stresses and cortical bone remodeling
,” in: Bourne, J. R., ed.,
CRC critical reviews in bioengineering
, Vol.
8
, CRC Press, Boca Raton, FL, pp.
1
28
.
3.
Carter
D. R.
,
1984
, “
Mechanical loading histories and cortical bone remodeling
,”
Calc. Tiss. Int.
, Vol.
36
, pp.
S19–S24
S19–S24
.
4.
Carter
D. R.
,
Orr
T. E.
, and
Fyhrie
D. P.
,
1989
, “
Relationships between loading history and femoral cancellous bone architecture
,”
J. Biomech.
, Vol.
22
, pp.
231
244
.
5.
Engh
C. A.
, and
Bobyn
J. D.
,
1988
, “
The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty
,”
Clin. Orthop. Rel. Res.
, Vol.
231
, pp.
7
28
.
6.
Engh
C. A.
,
O’Connor
D.
,
Jasty
M.
,
McGovern
T. F.
,
Bobyn
J. D.
, and
Harris
W. H.
,
1992
, “
Quantification of implant micromotion, strain shielding, and bone resorption with porous coated anatomic medullary locking femoral prostheses
,”
Clin. Orthop. Rel. Res.
, Vol.
285
, pp.
13
29
.
7.
Frost
H. M.
,
1983
, “
A determinant of bone architecture. The minimum effective strain
,”
Clin. Orthop. Rel. Res.
, Vol.
175
, pp.
286
292
.
8.
Frost
H. M.
,
1987
, “
Vital Biomechanics. Proposed general concepts for skeletal adaptations to mechanical usage
,”
Calcif. Tissue. Int.
, Vol.
42
, pp.
145
156
.
9.
Huiskes
R.
,
Weinans
H.
,
Grootenboer
H. J.
,
Dalstra
M.
,
Fudala
B.
, and
Slooff
T. J.
,
1987
, “
Adaptive bone-remodeling theory applied to prosthetic-design analysis
,”
J. Biomech.
, Vol.
20
, pp.
1135
1150
.
10.
Huiskes
R.
,
Weinans
H.
, and
Dalstra
M.
,
1989
, “
Adaptive bone remodeling and biomechanical design considerations for noncemented total hip arthroplasty
,”
Orthopedics
, Vol.
12
, pp.
1255
1267
.
11.
Huiskes
R.
,
Weinans
H.
, and
Rietbergen
B. van
,
1992
, “
The relationship between stress shielding and bone resorption around total hip stems and the effects of flexible materials
,”
Clin. Orthop. Rel. Res.
, Vol.
274
, pp.
124
134
.
12.
Huiskes
R.
,
1993
, “
Stress shielding and bone-resorption in THA: clinical versus computer-simulation studies
,”
Acta Orthopaedica Belgica
, Vol.
59
Suppl. I, pp.
118
129
.
13.
Maloney
W. J.
,
Jasty
M.
,
Burke
D. W.
,
O’Conner
D. O.
,
Zalenski
W. B.
,
Bragdon
C.
, and
Harris
W. H.
,
1989
, “
Biomechanical and histologic investigation of cemented total hip arthroplasties. A study of autopsy-retrieved femurs after in vivo cycling
,”
Clin. Orthop. Rel. Res.
, Vol.
249
, pp.
129
140
.
14.
Nauenberg, T., Bouxsein, M. L., Mikic, B., and Carter, D. R., 1993, “Using clinical data to improve computational bone remodeling theory,” Transactions of the 39th Annual Meeting of the Orthopaedic Research Society, San Francisco, CA, p. 123.
15.
Orr
T. E.
,
Beaupre´
G. S.
,
Carter
D. R.
, and
Churman
D. J.
,
1990
, “
Computer predictions of bone remodeling around porous-coated implants
,”
J. Arthropl.
, Vol.
5
, pp.
191
200
.
16.
Rietbergen
B. van
,
Huiskes
R.
,
Weinans
H.
,
Summer
D. R.
,
Turner
T. M.
, and
Galante
J. O.
,
1993
, “
The mechanism of bone remodeling and resorption around press-fitted THA stems
,”
J. Biomech.
, Vol.
26
, pp.
369
382
.
17.
Weinans
H.
,
Huiskes
R.
,
Rietbergen
B. van
,
Summer
R.
,
Turner
T. U.
, and
Galante
J. O.
,
1993
, “
Validation of adaptive bone-remodeling analysis to predict bone morphology around noncemented THA
,”
J. Orthop. Res.
, Vol.
11
, pp.
500
513
.
This content is only available via PDF.
You do not currently have access to this content.