Timothy P. Harrigan

Limitations of the continuum assumption in cancellous bone

Most existing stress analyses of the skeleton which consider cancellous bone assume that it can be modelled as a continuum. In this paper we develop a criterion for the validity of this assumption. The limitations of the continuum assumption appear in two areas: near biologic interfaces, and in areas of large stress gradients. These limitations are explored using a probabilistic line scanning model for density measurement, resulting in an estimate of density accuracy as a function of line length which is experimentally verified. Within three to five trabeculae of an interface, a continuum model is suspect. When results as predicted using continuum analyses vary by more than 20-30% over a distance spanning three to five trabeculae, the results are suspect.

A three-dimensional non-linear finite element study of the effect of cement-prosthesis debonding in cemented femoral total hip components☆

A three-dimensional non-linear finite element analysis of a cemented femoral component in which the component was partially debonded from the cement mantle was used to assess the effects of debonding on stresses in the cement. Three cases of partial cement-metal debonding were modelled with debonding of the proximal portion of the implant down to a horizontal plane which was 35, 62.5, or 82.5 mm below the prosthesis collar. Each situation was studied under loads simulating both gait and stairclimbing. Also, complete debonding between the implant and the surrounding cement mantle was modeled for loads simulating gait. Under stair climbing loads with partial cement-mental debonding, hoop stresses of 13-18 MPa were observed in the cement at the cement-metal interface at the proximal postero-medial corner of the implant. Similarly, in stair climbing, the maximum principal stresses in the cement were also adjacent to the proximal postero-medial region of the implant. These stresses were compressive and increased from 15 MPa with fully bonded interfaces to 48 MPa with debonding down to 82.5 mm below the prosthesis collar. Under gait loads, complete debonding caused high compressive stresses up to 34.9 MPa in the cement distal to the prosthesis tip. Thus, cement failure subsequent to prosthesis debonding is likely in the proximal region in a partially debonded implant due to stair climbing loads and is likely below the prosthesis tip in a fully debonded implant due to gait loading.

Determination of loading parameters in the canine hip in vivo

The loading parameters in the canine hip were determined from multiple studies, involving the collection of kinematic and force plate data in vivo joint reaction force from an instrumented hip replacement prosthesis, and in vivo femoral cortical bone strain gauge data in different dogs. In the middle of the stance phase of gait the canine femur was flexed 110 degrees with respect to the pelvis and formed a 20 degree angle relative to the floor. At this point in the gait cycle, a line passing from the superior to the inferior aspect of the pubic symphysis was parallel to the floor. The joint reaction force measurements showed that the net force vector during midstance was directed inferiorly, posteriorly, and laterally, with a peak magnitude of up to 1.65 times the body weight. A torsional moment of 1.6 N m is exerted about the femoral shaft. In vivo strain data showed that during gait peak compressive strains of -300 to -502 microstrain were produced on the medial aspect of the femoral cortex and peak tensile strains of +250 to +458 midstrain were produced on the femoral cortex. At the midstance phase of gait, principal cortical bone strains were rotated up to 29 degrees relative to the long axis of the femur, suggesting torsional loads on the femur. These data in combination provide valuable insights on the loading parameters of the canine hip which can be used in future applications of the canine as a model for evaluating mechanically based phenomena such as bone ingrowth and remodeling or hip prostheses.

The effect of centrifuging bone cement

We have tested the porosity and fatigue life of five commonly used bone cements: Simplex P, LVC, Zimmer regular, CMW and Palacos R. Tests were conducted with and without centrifugation and with the monomer at room temperature and, except for LVC, at 0 degrees C. We found that the fatigue life of different specimens varied by a factor of nearly 100. It did not depend on porosity alone, but was more influenced by the basic composition of the cement. Simplex P when mixed with monomer at 0 degrees C and centrifuged for 60 seconds had the highest fatigue life and was still sufficiently liquid to use easily.

A Study of Intrusion Characteristics of Low Viscosity Cement Simplex-P and Palacos Cements in a Bovine Cancellous Bone Model

Aseptic loosening is the most common long-term complication of cemented total hip arthroplasties (THA). The functional longevity of these implants depends on the bone-cement interface. The influence of cement injection pressure, type of cement, ambient temperature, chilling of the monomer, and centrifugation of cement-on-cement intrusion depth was investigated in specimens of bovine cancellous bone. In order to validate the bovine model for comparative purposes relative to use in man, a linear relationship between human and bovine cancellous bone was first demonstrated for various porosities and cement intrusion depth. Three cements (Low Viscosity Cement [LVC], Simplex-P, and Palacos) were intruded at three different pressures (20, 40, and 60 PSI) at the same ambient temperature and relative humidity into commercially prepared plugs of bovine cancellous bone. Cement intrusion depth was proportional to injection pressure for all three cements, but was significantly different for each cement at a given pressure. At 20, 40, and 60 PSI, Palacos had a cement intrusion depth of 1.4, 2.4, and 2.8 mm respectively, while the figures for Simplex-P were 2.2, 4.2, and 5.0 mm, and for LVC were 8.0, 12.0, and 14.6 mm. Ambient temperature had an inverse relationship with cement intrusion depth for all three cements given the same experimental conditions. Chilling the monomer increased the intrusion of Simplex-P to 5.8, 8.2, and 12.7 mm at 20, 40, and 60 PSI injection pressure respectively. Simplex-P intrusion depth was not modified by cement centrifugation at any of the three injection pressures tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Porosity of various preparations of acrylic bone cements.

The total porosity and mean pore sizes of various bone cement preparations were measured using image analysis. The porosity in different commercial bone cements varied from 5% to 16% when these cements were prepared in the usual fashion. Centrifugation for 30 seconds resulted in a substantial reduction in the overall porosity of Simplex P, AKZ, Zimmer Regular, and CMW bone cements by reducing both the mean pore size and the number of pores per unit area. In contrast, the porosity of LVC, Palacos R, and Palacos R with gentamicin bone cements was not significantly decreased by centrifugation. Chilling the monomer before mixing resulted in higher porosity of both the centrifuged and uncentrifuged Simplex P, Zimmer Regular, and CMW bone cements. Simplex P mixed with chilled monomer and centrifuged for 120 seconds has one of the lowest porosities of the various cements, while retaining good handling characteristics and excellent fatigue strength.

A finite element study of the effect of diametral interface gaps on the contact areas and pressures in uncemented cylindrical femoral total hip components

Uncemented femoral total hip components rely entirely on contact with the prepared femur for their initial fixation. The contact areas and stresses between a straight tubular bone and a metal cylindrical prosthesis 12.5 cm long and 13 mm in diameter were calculated in a finite element model which includes uniform diametral gaps varying from 20 to 500 microns, using transverse loads from 100 to 2000 N. Frictionless three-dimensional contact elements were used between the bone and the prosthesis. Contact stresses were high and irregular in all cases, and the contact areas were small. Two regions of contact were apparent for lower loads and larger gaps. A third region of contact occurred near the distal tip of the implant at higher loads. This region of contact markedly increased the contact stresses at the distal tip of the prosthesis. A 20 microns overlap between bone and implant was modelled to assess a slight interference fit. The contact stress distribution in this case was markedly different from the stress distribution with a 20 microns diametral gap. The data collectively indicates that gaps of less than 20 microns between bone and implant can substantially change contact stress distributions.

A DOUBLE-BLIND STUDY ON THE EFFECTS OF A CAPACITIVELY COUPLED ELECTRICAL FIELD ON BONE INGROWTH INTO POROUS-SURFACED CANINE TOTAL HIP PROSTHESES

The effect of a capacitively coupled electrical field on bone ingrowth into titanium fiber mesh porous-surfaced canine total hip arthroplasties (THAs) was investigated in a double-blind experiment. The electrical field was induced by an external source delivering a 60-kHz 5-6-V peak-to-peak sinusoid voltage through skin electrodes. No significant increase in the ingrowth of bone into the porous coating occurred at the end of six weeks of electrical stimulation. The amount of bone that grew into the porous surface, the areal density of bone within the available pore space, and the extent of the prosthesis surface area with bone ingrowth or apposition were not significantly different in the control and stimulated groups. This particular form of electrical stimulation does not improve bone ingrowth into porous-surfaced canine THAs by six weeks.