Risk of failure during gait for direct skeletal attachment of a femoral prosthesis: A finite element study
Risk of failure during gait for direct skeletal attachment of a femoral prosthesis: A finite element study
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DOI：
10.1016/j.medengphy.2008.11.015
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发表时间：
2009-06-01
影响因子：
2.2
通讯作者：
Viceconti, Marco
中科院分区：
文献类型：
--
作者：
Helgason, Benedikt;Palsson, Halldor;Viceconti, Marco
自九十年代初以来，经股截肢者的直接骨骼附着一直是临床试验的主题。这种附着方法使截肢者能够在髋关节周围不受限制地运动，获得更好的坐姿舒适度，通过骨知觉改善感觉反馈，改善肢体控制并减少软组织问题。然而，康复期的长度被截肢者和临床医生认为是一个缺点。本研究的目的是使用有限元分析 (FEA) 来估计股骨假体直接骨骼附着的患者在步态过程中失败的风险。材料特性和载荷源自受试者特定数据，并且假设通过骨向内生长到多孔植入物表面来确保植入物稳定性。使用简化的有限元分析来优化种植体的承载能力方面的几何形状。然后将所得几何形状应用于特定主题的有限元研究。结果表明，植入物系统的失效风险大约是完整股骨预期失效风险的三倍。根据计算出的失效风险因素，主要结论是多孔涂层植入物可能有利于骨整合固定。还建议，所提出的方法可用于未来的研究，探索骨整合固定的机械稳定性，以改善下肢截肢者的直接骨骼附着。 (C) 2008 年 IPEM。由爱思唯尔有限公司出版。保留所有权利。
Direct skeletal attachments for transfemoral amputees have been the subject of clinical trials since the early nineties. This method of attachment allows the amputee an unrestricted range of motion around the hip joint, better sitting comfort, improved sensory feedback through osseoperception, improved limb control and reduced soft tissue problems. However, the length of the rehabilitation period is perceived as a shortcoming by the amputees and the clinicians. The aim of the present study is to estimate the risk of failure during gait, for a patient with direct skeletal attachment of a femoral prosthesis, using finite element analysis (FEA).Material properties and loads were derived from subject-specific data and implant stability assumed secured by bone ingrowth into a porous implant surface. A simplified FEA was used to optimize the implant geometry with respect to load bearing capacity. The resulting geometry was then implemented in a subject-specific FE study. The results indicate that the risk of failure for the implant system is approximately three times greater than what can be expected for an intact femur.The main conclusion, based on the risk of failure factors calculated, is that it is likely that a porous-coated implant could be beneficial for osseointegrated fixation. It is also suggested that the proposed methodology can be used in future studies exploring the mechanical stability of osseointegrated fixation in the view of improving direct skeletal attachments for lower limb amputees. (C) 2008 IPEM. Published by Elsevier Ltd. All rights reserved.