FE stress analysis of the interface between the bone and an osseointegrated implant for amputees - Implications to refine the rehabilitation program

Lee, Winson C. C., Doocey, Jacinta M., Branemark, Rickard, Adam, Clayton J., Evans, John H., Pearcy, Mark J., & Frossard, Laurent A. (2008) FE stress analysis of the interface between the bone and an osseointegrated implant for amputees - Implications to refine the rehabilitation program. Clinical Biomechanics, 23(10), pp. 1243-1250.

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BACKGROUND: The direct anchorage of lower-limb prosthesis to the bone has been shown to be an excellent alternative for amputees experiencing complications in using a conventional prosthetic socket. During rehabilitation phase, amputees are asked to apply static loading on the abutment perpendicular to a weigh scale to prepare the bone to tolerate the forces likely to be developed during walking. The weigh scale measures only the vertical force. A different loading protocol can affect the bone-implant interface stresses and the outcome of the rehabilitation. METHODS: This study developed a Finite Element model to study the stresses in the bone adjacent to the implant. Three loading conditions were applied based on the experimentally measured load: (1) vertical force applied along the long axis of the limb, corresponding to the load clinically prescribed in the weight bearing exercise; (2) loads applied on the three axes, corresponding to the "true" load measured simultaneously by a tri-axial load transducer during the same exercise; and (3) loads experienced during independent walking. FINDINGS: The model revealed that the weigh scale might in fact be applying much higher and less uniform stresses on the bone than expected. During walking, high stress occurred at various locations of the implanted region, which was different from the patterns of stress distribution during weight bearing exercises. INTERPRETATIONS: The difference in stress among three loading conditions implies that tri-axial load should be monitored during the weight bearing exercises and carefully prescribed.

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16 citations in Web of Science®

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ID Code: 15033
Item Type: Journal Article
Refereed: Yes
Additional Information: For more information, please refer to the journal's website (see hypertext link) or contact the author.
Keywords: Transfemoral amputation, Bone anchorage prosthetics, Osseointegration, Weight bearing exercise, Finite element modelling, Bone–implant stresses
DOI: 10.1016/j.clinbiomech.2008.06.012
ISSN: 0268-0033
Subjects: Australian and New Zealand Standard Research Classification > ENGINEERING (090000) > BIOMEDICAL ENGINEERING (090300) > Biomedical Engineering not elsewhere classified (090399)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2008 Elsevier
Deposited On: 07 Oct 2008 00:00
Last Modified: 29 Feb 2012 13:44

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