A novel thermodynamic bone remodeling framework for artificial joint optimization

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Artificial joint prostheses are used to replace diseased articular surfaces and provide pain relief for patients. After approximately 10 years of service, these artificial joints often cause major complications such as, bone re-fracture, infection and implant failure. These failed implants need to be replaced through costly revision surgeries, that are more difficult with less satisfactory outcomes compared to the primary replacement. These complications have been linked to the production of wear particles at the articular joint surface and bone loss also known as bone remodeling at the bone-implant interface. This bone remodeling is a major issue in artificial joint replacement particularly for elderly patients suffering from osteoporosis or osteoarthritis. Currently, most implants used in joint replacements are made from stiff materials such as titanium and cobalt-chrome alloys. The use of such implants changes the levels of stress within the bone, resulting in bone remodeling adjacent to the implant. Therefore, it is important to understand, monitor and control the remodeling that occurs around implants. The aim of this research is to improve the joint implants design by developing, implementing and validating an advanced mathematical framework for bone remodeling. This unique mathematical framework uses irreversible thermodynamics to combine all factors, mechanical, and metabolic (biological and chemical) which are simultaneously at play in the bone remodeling process. This advanced model has multiple potential applications in predicting bone remodeling and patient therapy. In the short term, it will assist in improving the design of metallic and biomimetic prostheses. It will also be used to assess and monitor the risk of bone re-fracture after surgical procedures such as total hip and hip resurfacing arthroplasty. Over the long term it can form a basis for virtual simulations of bone diseases associated with bone resorption such as osteoporosis, which will allow for the development of new therapeutic strategies.