Effect of the material's stiffness on stress-shielding in osseointegrated implants for bone-anchored prostheses: a numerical analysis and initial benchmark data
Effect of the material's stiffness on stress-shielding in osseointegrated implants for bone-anchored prostheses: a numerical analysis and initial benchmark data
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DOI：
10.37190/abb-01543-2020-02
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发表时间：
2020-01-01
影响因子：
1
通讯作者：
Sajewicz, Eugeniusz
中科院分区：
文献类型：
--
作者：
Prochor, Piotr;Frossard, Laurent;Sajewicz, Eugeniusz
目的：本研究试图建立骨锚式假体的种植体设计和应力遮挡之间的联系，使用数值方法影响骨-种植体耦合的稳定性。目的是共享能够评价植入物长期稳定性的数值模型，并使用该模型提取数据集，显示螺纹、压配和组配式压配植入物的形状和材料刚度如何影响应力屏蔽强度。方法：考虑了三种设计：螺纹、压配和模块化压配。使用杨氏模量（10至210 GPa）评估每个设计的形状和材料刚度对应力屏蔽强度的影响。此外，研究了组配式压配植入物经皮部分直径（10 - 18 mm）和髓部分厚度（5 - 1 mm）的影响。结果如下：螺纹设计在股骨远端产生4%以上的骨量丢失，但总体骨量丢失比压配设计低5%。对于组配式压配种植体，杨氏模量对骨量变化的影响是显著的，取决于经皮或髓内部分的直径。对于直径为18 mm和10 mm的经皮部件，20 GPa的刚度变化分别导致骨量从0.65%变化至2.45%和从0.07%变化至0.32%。结论：结果表明，尽管股骨远端骨丢失增加，但螺纹植入物提供了更大的稳定性。总而言之，这项工作提供了一个初始模型，可以应用于当前和即将推出的植入物的长期稳定性的后续研究。
Purpose: This study attempted to establish the link between design of implants for bone-anchored prostheses and stress-shielding, affecting the stability of the bone-implant coupling using numerical approach. The objectives were to share a numerical model capable to evaluate the long-term stability of implants and to use this model to extract data sets showing how shape and material stiffness of threaded, press-fit and modular press-fit implants affect stress-shielding intensity. Methods: Three designs were considered: threaded, press-fit and modular press-fit. The effect of shape and material stiffness of each design on stress-shielding intensity was assessed using Young's modulus (10 to 210 GPa). Furthermore, the impact of the diameter of percutaneous part (10 to 18 mm) and thickness of medullar part (5 to 1 mm) was investigated for the modular press-fit implant. Results: The threaded design generated 4% more bone mass loss at the distal femur but an overall loss of bone mass was by 5% lower to press-fit design. The influence of Young's modulus on bone mass changes was noticeable for modular press-fit implant, depending on diameter of percutaneous or medullary part. A 20 GPa change of stiffness caused a bone mass change from 0.65% up to 2.45% and from 0.07% up to 0.32% for percutaneous parts with 18 mm and 10 mm diameter, respectively. Conclusions: Results suggested that threaded implant provides greater stability despite an increased bone loss at the distal femur. Altogether, this work provided an initial model that could be applied in subsequent studies on the long-term stability of current and upcoming implants.