Abstract
Stress shielding-related bone loss occurs after total hip arthroplasty because the stiffness of metallic implants differs from that of the host femur. Although reducing stem stiffness can ameliorate the bone resorption, it increases stress at the bone–implant interface and can inhibit fixation. To overcome this complication, a novel cementless stem with a gradient in Young's modulus was developed using Ti-33.6Nb-4Sn (TNS) alloy. Local heat treatment applied at the neck region for increasing its strength resulted in a gradual decrease in Young's modulus from the proximal to the distal end, from 82.1 to 51.0 GPa as calculated by a heat transfer simulation. The Young's modulus gradient did not induce the excessive interface stress which may cause the surface debonding. The main purpose of this study was to evaluate bone remodeling with the TNS stem using a strain-adaptive bone remodeling simulation based on finite element analysis. Our predictions showed that, for the TNS stem, bone reduction in the calcar region (Gruen zone 7) would be 13.6% at 2 years, 29.0% at 5 years, and 45.8% at 10 years postoperatively. At 10 years, the bone mineral density for the TNS stem would be 42.6% higher than that for the similar Ti-6Al-4V alloy stem. The stress–strength ratio would be lower for the TNS stem than for the Ti-6Al-4V stem. These results suggest that although proximal bone loss cannot be eliminated completely, the TNS stem with a Young's modulus gradient may have bone-preserving effects and sufficient stem strength, without the excessive interface stress.
| Original language | English |
|---|---|
| Pages (from-to) | 135-143 |
| Number of pages | 9 |
| Journal | Journal of biomechanics |
| Volume | 63 |
| DOIs | |
| Publication status | Published - 3 Oct 2017 |
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Keywords
- Bone remodeling
- Finite element analysis
- Low modulus stem
- Stress shielding
- Total hip arthroplasty
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Improving stress shielding following total hip arthroplasty by using a femoral stem made of β type Ti-33.6Nb-4Sn with a Young's modulus gradation. / Yamako, Go; Janssen, Dennis; Hanada, Shuji; Anijs, Thomas; Ochiai, Kiyohide; Totoribe, Koji; Chosa, Etsuo; Verdonschot, Nico.
In: Journal of biomechanics, Vol. 63, 03.10.2017, p. 135-143.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Improving stress shielding following total hip arthroplasty by using a femoral stem made of β type Ti-33.6Nb-4Sn with a Young's modulus gradation
AU - Yamako, Go
AU - Janssen, Dennis
AU - Hanada, Shuji
AU - Anijs, Thomas
AU - Ochiai, Kiyohide
AU - Totoribe, Koji
AU - Chosa, Etsuo
AU - Verdonschot, Nico
PY - 2017/10/3
Y1 - 2017/10/3
N2 - Stress shielding-related bone loss occurs after total hip arthroplasty because the stiffness of metallic implants differs from that of the host femur. Although reducing stem stiffness can ameliorate the bone resorption, it increases stress at the bone–implant interface and can inhibit fixation. To overcome this complication, a novel cementless stem with a gradient in Young's modulus was developed using Ti-33.6Nb-4Sn (TNS) alloy. Local heat treatment applied at the neck region for increasing its strength resulted in a gradual decrease in Young's modulus from the proximal to the distal end, from 82.1 to 51.0 GPa as calculated by a heat transfer simulation. The Young's modulus gradient did not induce the excessive interface stress which may cause the surface debonding. The main purpose of this study was to evaluate bone remodeling with the TNS stem using a strain-adaptive bone remodeling simulation based on finite element analysis. Our predictions showed that, for the TNS stem, bone reduction in the calcar region (Gruen zone 7) would be 13.6% at 2 years, 29.0% at 5 years, and 45.8% at 10 years postoperatively. At 10 years, the bone mineral density for the TNS stem would be 42.6% higher than that for the similar Ti-6Al-4V alloy stem. The stress–strength ratio would be lower for the TNS stem than for the Ti-6Al-4V stem. These results suggest that although proximal bone loss cannot be eliminated completely, the TNS stem with a Young's modulus gradient may have bone-preserving effects and sufficient stem strength, without the excessive interface stress.
AB - Stress shielding-related bone loss occurs after total hip arthroplasty because the stiffness of metallic implants differs from that of the host femur. Although reducing stem stiffness can ameliorate the bone resorption, it increases stress at the bone–implant interface and can inhibit fixation. To overcome this complication, a novel cementless stem with a gradient in Young's modulus was developed using Ti-33.6Nb-4Sn (TNS) alloy. Local heat treatment applied at the neck region for increasing its strength resulted in a gradual decrease in Young's modulus from the proximal to the distal end, from 82.1 to 51.0 GPa as calculated by a heat transfer simulation. The Young's modulus gradient did not induce the excessive interface stress which may cause the surface debonding. The main purpose of this study was to evaluate bone remodeling with the TNS stem using a strain-adaptive bone remodeling simulation based on finite element analysis. Our predictions showed that, for the TNS stem, bone reduction in the calcar region (Gruen zone 7) would be 13.6% at 2 years, 29.0% at 5 years, and 45.8% at 10 years postoperatively. At 10 years, the bone mineral density for the TNS stem would be 42.6% higher than that for the similar Ti-6Al-4V alloy stem. The stress–strength ratio would be lower for the TNS stem than for the Ti-6Al-4V stem. These results suggest that although proximal bone loss cannot be eliminated completely, the TNS stem with a Young's modulus gradient may have bone-preserving effects and sufficient stem strength, without the excessive interface stress.
KW - Bone remodeling
KW - Finite element analysis
KW - Low modulus stem
KW - Stress shielding
KW - Total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85028722446&partnerID=8YFLogxK
U2 - 10.1016/j.jbiomech.2017.08.017
DO - 10.1016/j.jbiomech.2017.08.017
M3 - Article
AN - SCOPUS:85028722446
VL - 63
SP - 135
EP - 143
JO - Journal of biomechanics
JF - Journal of biomechanics
SN - 0021-9290
ER -