ArticleJournal of the mechanical behavior of biomedical materials2017
Strain shielding in trabecular bone at the tibial cement-bone interface.
Article in Journal of the mechanical behavior of biomedical materials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Comparison of medium- and long-term total knee arthroplasty follow-up with or without tourniquet.BMC musculoskeletal disorders · 2025Article
- Finite element study on the micromechanics of cement-augmented proximal femoral nail anti-rotation (PFNA) for intertrochanteric fracture treatment.Scientific reports · 2024Article
- Appearance and evolution of radiolucent lines below the tibial implant in primary total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Pathophysiological mechanism of acute bone loss after fracture.Journal of advanced research · 2023Review
- Computational tibial bone remodeling over a population after total knee arthroplasty: A comparative study.Journal of biomedical materials research. Part B, Applied biomaterials · 2022Article
- A review of biomaterials in bone defect healing, remaining shortcomings and future opportunities for bone tissue engineering: The unsolved challenge.Bone & joint research · 2018Article
- Trabecular resorption patterns of cement-bone interlock regions in total knee replacements.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2017Article
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Authors and funding
5 authors.
Funding
Abstract
Aseptic loosening of the tibial component remains the leading cause for revision surgery in total knee arthroplasty (TKA). Understanding the mechanisms leading to loss of fixation can offer insight into preventative measures to ensure a longer survival rate. In cemented TKA, loosening occurs at the cement-trabecular interface probably due to a stress-shielding effect of the stiffer implant material in comparison with bone. Using finite element models of lab-prepared tibial cement-trabeculae interface specimens (n=4) based on micro-CT images, this study aims to investigate the micromechanics of the interlock between cement and trabecular bone. Finite element micromotion between cement and trabeculae and bone strain were compared in the interdigitated trabeculae as well as strain in the bone distal to the interface. Lab-prepared specimens and their FE models were assumed to represent the immediate post-operative situation. The cement layer was removed in the FE models while retaining the loading conditions, which resulted in FE models that represented the pre-operative situation. Results showed that micromotion and bone strain decrease when interdigitation depth increases. Bone-cement micromotion and bone strain at the distal interdigitated region showed a dependence on bone volume fraction. Comparing the immediate post-operative and pre-operative situations, trabeculae embedded deep within the cement generally showed the highest level of strain-shielding. Strain shielding of interdigitated bone, in terms of reduction in compressive strains, was found to be between 35 and 61 % for the four specimens. Strain adaptive remodeling could thus be a plausible mechanism responsible for loss of interdigitated bone.
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