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dc.contributor.authorAl-Dirini, Rami M Aen_US
dc.contributor.authorMartelli, Sauloen_US
dc.contributor.authorO'Rourke, Dermoten_US
dc.contributor.authorHuff, Danielen_US
dc.contributor.authorZhang, Juen_US
dc.contributor.authorClement, John Gen_US
dc.contributor.authorBesier, Thoren_US
dc.contributor.authorTaylor, Marken_US
dc.date.accessioned2019-01-16T22:21:51Z
dc.date.available2019-01-16T22:21:51Z
dc.date.issued2018-11-15
dc.identifier.citationDirini, R. M. A., Martelli, S., O’Rourke, D., Huff, D., Zhang, J., Clement, J. G., … Taylor, M. (2019). Virtual trial to evaluate the robustness of cementless femoral stems to patient and surgical variation. Journal of Biomechanics, 82, 346–356. https://doi.org/10.1016/j.jbiomech.2018.11.013en_US
dc.identifier.issn0021-9290
dc.identifier.urihttp://hdl.handle.net/2328/38829
dc.description© 2018 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (November 2018) in accordance with the publisher’s archiving policyen_US
dc.description.abstractPrimary stability is essential for the success of cementless femoral stems. In this study, patient specific finite element (FE) models were used to assess changes in primary stability due to variability in patient anatomy, bone properties and stem alignment for two commonly used cementless femoral stems, Corail® and Summit® (DePuy Synthes, Warsaw, USA). Computed-tomography images of the femur were obtained for 8 males and 8 females. An automated algorithm was used to determine the stem position and size which minimized the endo-cortical space, and then span the plausible surgical envelope of implant positions constrained by the endo-cortical boundary. A total of 1952 models were generated and ran, each with a unique alignment scenario. Peak hip contact and muscle forces for stair climbing were scaled to the donor’s body weight and applied to the model. The primary stability was assessed by comparing the implant micromotion and peri-prosthetic strains to thresholds (150 μm and 7000 µε, respectively) above which fibrous tissue differentiation and bone damage are expected to prevail. Despite the wide range of implant positions included, FE prediction were mostly below the thresholds (medians: Corail®: 20–74 µm and 1150–2884 µε, Summit®: 25–111 µm and 860–3010 µε), but sensitivity of micromotion and interfacial strains varied across femora, with the majority being sensitive (p < 0.0029) to average bone mineral density, cranio-caudal angle, post-implantation anteversion angle and lateral offset of the femur. The results confirm the relationship between implant position and primary stability was highly dependent on the patient and the stem design used.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relationhttp://purl.org/au-research/grants/arc/LP130100122en_US
dc.rights© 2018 Elsevier Ltd.en_US
dc.subjectHip replacementen_US
dc.subjectImplant designen_US
dc.subjectSurgical planningen_US
dc.subjectFinite element modellingen_US
dc.subjectPrimary stabilityen_US
dc.subjectPatient factorsen_US
dc.subjectImplant robustnessen_US
dc.titleVirtual trial to evaluate the robustness of cementless femoral stems to patient and surgical variationen_US
dc.typeArticleen_US
dc.relation.grantnumberARC/LP130100122en_US
dc.identifier.doihttps://doi.org/10.1016/j.jbiomech.2018.11.013en_US
dc.rights.holderElsevier Ltd.en_US
dc.rights.licenseCC-BY-NC-ND
local.contributor.authorOrcidLookupAl-Dirini, Rami M A: https://orcid.org/0000-0001-6412-6057en_US
local.contributor.authorOrcidLookupMartelli, Saulo: https://orcid.org/0000-0002-0012-8122en_US
local.contributor.authorOrcidLookupZhang, Ju: https://orcid.org/0000-0002-2282-8146en_US
local.contributor.authorOrcidLookupTaylor, Mark: https://orcid.org/0000-0001-7842-6472en_US


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