In Silico Assessment of Connective Tissue Formation on Proximal Surfaces of Femoral Stem with Different Implant Materials

Clinical success of uncemented total hip arthroplasty hinges on stability of fixation of the implanted femoral component. Surgical technique and implant geometry contribute in primary stability, while subsequent secondary stability is accomplished by osseointegration during the healing process. Periprosthetic connective tissue growth secures endosteal fixation, enhancing long term stability. Osseointegration can be improved by changing the material, surface topology and geometric design of implants. Despite attempts to study the evolutionary bone growth using finite element analysis (FEA) coupled with bio-mechanoregulation, there has been a few investigations on periprosthetic tissue differentiation comparing implant stiffness. In the current study, FE analysis is performed on a virtually implanted patient-specific 3D femur model subjected to normal walking. The aim of this study is to predict and compare the emerging connective tissues around prostheses of different stiffness. Results from this study also provide predictive analysis of tissue differentiation and their temporal distribution around a hip implant under normal walking over a post-surgery period of eight weeks.