DOI QR코드

DOI QR Code

Simulation of tissue differentiation around acetabular cups: the effects of implant-bone relative displacement and polar gap

  • Mukherjee, Kaushik (Department of Mechanical Engineering, Indian Institute of Technology Kharagpur) ;
  • Gupta, Sanjay (Department of Mechanical Engineering, Indian Institute of Technology Kharagpur)
  • Received : 2013.10.10
  • Accepted : 2014.01.24
  • Published : 2014.04.25

Abstract

Peri-acetabular bone ingrowth plays a crucial role in long-term stability of press-fit acetabular cups. A poor bone ingrowth often results in increased cup migration, leading to aseptic loosening of the implant. The rate of peri-prosthetic bone formation is also affected by the polar gap that may be introduced during implantation. Applying a mechano-regulatory tissue differentiation algorithm on a two-dimensional plane strain microscale model, representing implant-bone interface, the objectives of the study are to gain an insight into the process of peri-prosthetic tissue differentiation and to investigate its relationship with implant-bone relative displacement and size of the polar gap. Implant-bone relative displacement was found to have a considerable influence on bone healing and peri-acetabular bone ingrowth. An increase in implant-bone relative displacement from $20{\mu}m$ to $100{\mu}m$ resulted in an increase in fibrous tissue formation from 22% to 60% and reduction in bone formation from 70% to 38% within the polar gap. The increase in fibrous tissue formation and subsequent decrease in bone formation leads to weakening of the implant-bone interface strength. In comparison, the effect of polar gap on bone healing and peri-acetabular bone ingrowth was less pronounced. Polar gap up to 5 mm was found to be progressively filled with bone under favourable implant-bone relative displacements of $20{\mu}m$ along tangential and $20{\mu}m$ along normal directions. However, the average Young's modulus of the newly formed tissue layer reduced from 2200 MPa to 1200 MPa with an increase in polar gap from 0.5 mm to 5 mm, suggesting the formation of a low strength tissue for increased polar gap. Based on this study, it may be concluded that a polar gap less than 0.5 mm seems favourable for an increase in strength of the implant-bone interface.

Keywords

References

  1. Andreykiv, A., van Keulen, F. and Prendergast, P.J. (2008), "Simulation of fracture healing incorporating mechanoregulation of tissue differentiation and dispersal/proliferation of cells", Biomech. Model Mechanobiol., 7(6), 443-461. https://doi.org/10.1007/s10237-007-0108-8
  2. Back, D.L., Dalziel, R., Young, D. and Shimmin, A. (2005), "Early results of primary Birmingham hip resurfacings: An independent prospective study of the first 230 hips", J. Bone Joint Surg. Br., 87(3), 324-329.
  3. Bloebaum, R.D., Bachus, K.N., Jensen, J.W. and Hofmann, A.A. (1997), "Postmortem analysis of consecutively retrieved asymmetric porous-coated tibial components", J. Arthroplasty, 12(8), 920-929. https://doi.org/10.1016/S0883-5403(97)90162-5
  4. Bragdon, C., Jasty, M., Greene, M., Rubash, H.E. and Harris, W.H. (2004), "Biologic fixation of total hip implants: Insights gained from a series of canine studies", J. Bone Joint Surg. Am., 86, 105-117. https://doi.org/10.2106/00004623-200412002-00015
  5. Carter, D.R., Blenman, P.R. and Beaupre, G.S. (1988), "Correlations between mechanical stress history and tissue differentiation in initial fracture healing", J. Orthop. Res., 6(5), 736-748. https://doi.org/10.1002/jor.1100060517
  6. Claes, L.E. and Heigele, C.A. (1999), "Magnitudes of local stress and strain along bony surfaces predict the course and type of fracture healing", J. Biomech., 32(3), 255-266. https://doi.org/10.1016/S0021-9290(98)00153-5
  7. Chou, H.Y. and Muftu, S. (2013), "Simulation of peri-implant bone healing due to immediate loading in dental implant treatments", J. Biomech., 46(14), 871-878. https://doi.org/10.1016/j.jbiomech.2012.12.023
  8. Curtis, M.J., Jinnah, R.H. and Wilson, V.D. (1992), "The initial stability of uncemented acetabular components", J. Bone Joint Surg. Br., 74(3), 372-376.
  9. Daniel, J., Pynsent, P.B. and McMinn, D.J.W. (2004), "Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis." J. Bone Joint Surg. Br., 86(2), 177-184. https://doi.org/10.1302/0301-620X.86B2.14600
  10. Davies, J.E. (1996), "In vitro modeling of the bone/implant interface", Anat. Rec., 245(2), 426-445. https://doi.org/10.1002/(SICI)1097-0185(199606)245:2<426::AID-AR21>3.0.CO;2-Q
  11. Davies, J.E. (2003), "Understanding peri-implant endosseous healing", J. Dent. Edu., 67(8), 932-949.
  12. Dickinson, A., Taylor, A. and Browne, M. (2012), "Implant-bone interface healing and adaptation in resurfacing hip replacement", Comp. Method. Biomech. Biomed. Engin., 15(9), 935-947. https://doi.org/10.1080/10255842.2011.567269
  13. Engh, C.A., Bobyn, J.D. and Glassman, A.H. (1987), "Porous-coated Hip replacement: The factors governing bone ingrowth, stress shielding, and clinical results", J. Bone Joint Surg. Br., 69(1), 45-55.
  14. Engh, C.A., Zettl-Schaffer, K.F., Kukita, Y., Sweet, D., Jasty, M. and Bragdon, C. (1993), "Histological and radiographic assessment of well functioning porous-coated acetabular components. A human postmortem retrieval study", J. Bone Joint Surg. Am., 75(6), 814-824. https://doi.org/10.2106/00004623-199306000-00003
  15. Ghosh, R., Mukherjee, K. and Gupta, S. (2013), "Bone remodelling around uncemented metallic and ceramic acetabular components", Proc. Inst. Mech. Eng. H., 227(5), 490-502.
  16. Haddad, R.J., Cook, S.D. and Thomas, K.A. (1987), "Biological fixation of porous-coated implants", J. Bone Joint Surg. Am., 69(9), 1459-1466. https://doi.org/10.2106/00004623-198769090-00026
  17. Hanzlik, J.A. and Day, J.S. (2013), "Bone ingrowth in well-fixed retrieved porous tantalum implants", J. Arthroplasty, 28, 922-927. https://doi.org/10.1016/j.arth.2013.01.035
  18. Hollister, S.J., Guldberg, R.E., Kuelske, C.L., Caldwell, N.J., Richards, M. and Goldstein, S.A. (1996), "Relative effects of wound healing and mechanical stimuls on early bone response to porous-coated implants", J. Orthop. Res., 14(4), 654-662. https://doi.org/10.1002/jor.1100140422
  19. Huiskes, R., van Driel, W.D., Prendergast, P.J. and Soballe, K. (1997), "A biomechanical regulatory model for periprosthetic fibrous tissue differentiation", J. Mater. Sci. Mater. Med., 8(12), 785-788. https://doi.org/10.1023/A:1018520914512
  20. Isaac, G.H., Siebel, T., Schmalzried, T.P., Cobb, A.G., O'Sullivan, T., Oakeshott, R.D., Flett, M. and Vail, T.P. (2006), "Development rationale for an articular surface replacement: a science-based evolution", Proc. Inst. Mech. Eng. H., 220(2), 253-268.
  21. Isaksson, H., Wilson, W., van Donkelaar, C.C., Huiskes, R. and Ito, K. (2006), "Comparison of biophysical stimuli for mechanoregulation of tissue differentiation during fracture healing", J. Biomech., 39(8), 1507-1516. https://doi.org/10.1016/j.jbiomech.2005.01.037
  22. Itayem, R., Arndt, A., Nistor, L., McMinn, D. and Lundberg, A. (2005), "Stability of the Birmingham hip resurfacing at two years:Aradiostereophotogrammetric analysis study", J. Bone Joint Surg. Br., 87(2), 158-162
  23. Jasty, M., Bragdon, C.R., Maloney, W.J., Haire, T. and Harris, W.H. (1991), "Ingrowth of bone in failed fixation of porous-coated femoral components", J. Bone Joint Surg. Am., 73(9), 1331-1337. https://doi.org/10.2106/00004623-199173090-00007
  24. Jasty, M., Bragdon, C.R., Burke, D., O'Connor, D., Lowenstein, J. and Harris, W.H. (1997), "In vivo skeletal responses to porous-surfaced implants subjected to small induced motions", J. Bone Joint Surg. Am., 79(5), 707-714. https://doi.org/10.2106/00004623-199705000-00010
  25. Lacroix, D. and Prendergast, P.J. (2000), "A homogenization procedure to prevent numerical instabilities in poroelastic tissue differentiation models", Proceedings of 8th Symposium on Computational Methods in Orthopaedic Biomechanics, Orlando FL, March.
  26. Lacroix, D. and Prendergast, P.J. (2002), "A mechano-regulation model for tissue differentiation during fracture healing: analysis of gap size and loading", J. Biomech., 35(9), 1163-1171. https://doi.org/10.1016/S0021-9290(02)00086-6
  27. Lacroix. D., Prendergast, P.J., Li, G. and Marsh, D. (2002), "Biomechanical model to simulate tissue differentiation and bone regeneration: application to fracture healing", Med. Biol. Eng. Comput., 40(1), 14-21. https://doi.org/10.1007/BF02347690
  28. Liu, X. and Niebur, G.L. (2008), "Bone ingrowth into a porous coated implant predicted by a mechanoregulatory tissue differentiation algorithm", Biomech. Model Mechanobiol., 7(4), 335-344. https://doi.org/10.1007/s10237-007-0100-3
  29. MacKenzie, J.R., Callaghan, J.J., Pedersen, D.R. and Brown, T.D. (1994), "Areas of contact and extent of gaps with implantation of oversized acetabular components in total hip arthroplasty", Clin. Orthop. Relat. Res., 298, 127-136.
  30. Manley, M.T., Ong, K.L. and Kurtz, S.M. (2006), "The potential for bone loss in acetabular structures following THA", Clin. Orthop. Relat. Res, 453, 246-253. https://doi.org/10.1097/01.blo.0000238855.54239.fd
  31. McMinn, D. and Daniel, J. (2006), "History and modern concepts in surface replacement", Proc. Inst. Mech. Eng. H., 220, 239-251.
  32. Morrison, M.L. (2006), Birmingham Hip Resurfacing System, Materials and Processes for Medical Devices, October.
  33. Nakasone, S., Takao, M., Nishii, T., Sakai, T. and Sugano, N. (2012), "Incidence and Natural Course of Initial Polar Gaps in Birmingham Hip Resurfacing Cups", J. Arthroplasty, 27(9), 1676-1682. https://doi.org/10.1016/j.arth.2012.02.028
  34. National Joint Registry for England and Wales (2012), 9th Annual Report, Hemel, Hempstead, UK.
  35. Peters, C.L. and Miller, M.D. (2006), The Adult Hip, Lippincott Williams and Wilkins, USA.
  36. Pilliar, R.M., Lee, J.M. and Maniatopoulos, C. (1986), "Observations on the effect of movement on bone ingrowth into porous-surfaced implants", Clin. Orthop. Relat. Res., 208, 108-113.
  37. Prendergast, P.J., Huiskes, R. and Soballe, K. (1997), "Biophysical stimuli on cells during tissue differentiation at implant interfaces", J. Biomech., 30(6), 539-548. https://doi.org/10.1016/S0021-9290(96)00140-6
  38. Puleo, D.A. and Nanci, A. (1999), "Understanding and controlling the bone-implant interface", Biomater., 20(23-24), 2311-2321. https://doi.org/10.1016/S0142-9612(99)00160-X
  39. Puthumanapully, P.K. (2010), "Simulation of tissue differentiation in uncemented hip implants based on a mechanoregulatory hypothesis", Ph.D. Dissertation, University of Southampton, Southampton.
  40. Puthumanapully, P.K. and Browne, M. (2011), "Tissue differentiation around a short stemmed metaphyseal loading implant employing a modified mechanoregulatory algorithm: a finite element study", J. Orthop. Res., 29(5), 787-794. https://doi.org/10.1002/jor.21305
  41. Richardson, J.B., Cunningham, J.L., Goodship, A.E., O'Connor, B.T. and Kenwright, J. (1994), "Measuring stiffness can define healing of tibial fractures", J. Bone Joint Surg. Br., 76(3), 389-394.
  42. Sandborn, P.M., Cook, S.D., Spires, W.P. and Kester, M.A. (1988), "Tissue response to porous-coated implants lacking initial bone apposition", J. Arthroplasty, 3(4), 337-346. https://doi.org/10.1016/S0883-5403(88)80034-2
  43. Schmalzried, T.P., Wessinger, S.J., Hill, G.E. and Harris, W.H. (1994), "The Harris-Galante porous acetabular component press-fit without screw fixation, five-year radiographic analysis of primary cases", J. Arthroplasty, 9(3), 235-242. https://doi.org/10.1016/0883-5403(94)90077-9
  44. Slovakian Arthroplasty Register: Survival Analysis of Total Hip and Knee Replacement in Slovakia (2003-2011), Annual Report, Slovakia
  45. Springer, B.D., Griffin, W.L., Fehring, T.K., Suarez, J., Odum, S. and Thompson, C. (2008), "Incomplete seating of press-fit porous-coated acetabular components: the fate of zone 2 lucencies", J. Arthroplasty, 23(6), 121-126. https://doi.org/10.1016/j.arth.2008.04.011
  46. Takao, M., Nakamura, N., Ohzono, K., Sakai, T., Nishii, T. and Sugano, N. (2011), "The results of a pressfit-only technique for acetabular fixation in hip dysplasia", J. Arthroplasty, 26(4), 562-568. https://doi.org/10.1016/j.arth.2010.05.025
  47. The New Zealand Joint Registry: Thirteen Year Report January 1999 to December 2011 (2012), New Zealand Orthopaedic Association, Wellington, New Zealand.
  48. The Norwegian Arthroplasty Register (2010), Haukeland University Hospital, Haukeland, Norway.
  49. Treacy, R.B.C., McBryde, C.W. and Pynsent, P.B. (2005), "Birmingham hip resurfacing arthroplasty: a minimum follow-up of five years", J. Bone Joint Surg. Br., 87(2), 167-170.
  50. Treacy, R.B.C., McBryde, C.W., Shears, E. and Pynsent, P.B. (2011), "Birmingham hip resurfacing", J. Bone Joint Surg. Br., 93(1), 27-33.
  51. Udomkiat, P., Dorr, L.D. and Wan, Z. (2002), "Cementless hemispheric porous-coated sockets implanted with press-fit technique without screws: average ten-year follow-up", J. Bone Joint Surg. Am., 84(7), 1195-1200. https://doi.org/10.2106/00004623-200207000-00016
  52. US Food and Drug Administration (FDA) (2006), Birmingham Hip Resurfacing (BHR) System, online available at: http://www.accessdata.fda.gov/cdrh_docs/pdf4/P040033b.pdf.

Cited by

  1. Bone ingrowth around porous-coated acetabular implant: a three-dimensional finite element study using mechanoregulatory algorithm vol.15, pp.2, 2016, https://doi.org/10.1007/s10237-015-0696-7
  2. The effects of musculoskeletal loading regimes on numerical evaluations of acetabular component vol.230, pp.10, 2016, https://doi.org/10.1177/0954411916661368
  3. A mechano-biological model of multi-tissue evolution in bone 2017, https://doi.org/10.1007/s00161-017-0611-9
  4. Mechanobiological simulations of peri-acetabular bone ingrowth: a comparative analysis of cell-phenotype specific and phenomenological algorithms vol.55, pp.3, 2017, https://doi.org/10.1007/s11517-016-1528-3
  5. Influence of Implant Surface Texture Design on Peri-Acetabular Bone Ingrowth: A Mechanobiology Based Finite Element Analysis vol.139, pp.3, 2017, https://doi.org/10.1115/1.4035369
  6. Combined Bone Ingrowth and Remodeling Around Uncemented Acetabular Component: A Multiscale Mechanobiology-Based Finite Element Analysis vol.139, pp.9, 2017, https://doi.org/10.1115/1.4037223