S.E. Basler

Time-lapsed imaging of implant fixation failure in human femoral heads

The failure mechanisms of bone-implant constructs are still incompletely understood, because the role of the peri-implant bone in implant stability is unclear. We hypothesized that implant fixation failure is preceded by substantial peri-implant bone failure. A new device was developed that combines mechanical testing of large bone-implant constructs with high-resolution peripheral quantitative computed tomography, following the principles of image-guided failure assessment (IGFA). In this study, we investigated the push-in failure behavior of dynamic hip screws (DHS) implanted in human cadaveric femoral heads. For the first time the fixation failure of a clinically used implant in human trabecular bone could be experimentally visualized at the microstructural level. The ultimate force was highly correlated with the peri-implant bone volume fraction (R(2)=0.85). We demonstrated that primary fixation failure of DHS implants was accompanied by trabecular bone failure in the immediate peri-implant bone region only. Such experimental data are crucial to enhance the understanding on the quality of the bone-implant interface and of the trabecular bone in the process of implant fixation failure. We believe that this newly developed device will be beneficial for the development of new implant designs, especially for use in osteoporotic bone.

Towards validation of computational analyses of peri-implant displacements by means of experimentally obtained displacement maps

Micro-finite element (μFE) analysis has recently been introduced for the detailed quantification of the mechanical interaction between bone and implant. The technique has been validated at an apparent level. The aim of this study was to address the accuracy of μFE analysis at the trabecular level. Experimental displacement fields were obtained by deformable image registration, also known as strain mapping (SM), of dynamic hip screws implanted in three human femoral heads. In addition, displacement fields were calculated using μFE analysis. On a voxel-by-voxel basis, the coefficients of determination (R2) between experimental and μFE-calculated displacements ranged from 0.67 to 0.92. Linear regression of the mean displacements over nine volumes of interest yielded R2 between 0.81 and 0.84. The lowest R2 values were found in regions of very small displacements. In conclusion, we found that peri-implant bone displacements calculated with μFE analysis correlated well with displacements obtained from experimental SM.