TY - JOUR
T1 - Improving peri-prosthetic bone adaptation around cementless hip stems: A clinical and finite element study
AU - ten Broeke, R.H.M.
AU - Tarala, M.
AU - Arts, J.J.
AU - Janssen, D.W.
AU - Verdonschot, Nicolaas Jacobus Joseph
AU - Geesink, R.G.T.
PY - 2014
Y1 - 2014
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 - IR-97105
KW - METIS-301811
U2 - 10.1016/j.medengphy.2013.12.006
DO - 10.1016/j.medengphy.2013.12.006
M3 - Article
SN - 1350-4533
VL - 36
SP - 345
EP - 353
JO - Medical engineering & physics
JF - Medical engineering & physics
IS - 3
ER -