A computational analysis of a novel therapeutic approach combining an advanced medicinal therapeutic device and a fracture fixation assembly for the treatment of osteoporotic fractures: Effects of physiological loading, interface conditions, and fracture fixation materials. (April 2023)

• Record Type: Journal Article
• Authors: Mondal, Subrata; MacManus, David B.; Bonatti, Amedeo Franco; De Maria, Carmelo; Dalgarno, Kenny; Chatzinikolaidou, Maria; De Acutis, Aurora; Vozzi, Giovanni; Fiorilli, Sonia; Vitale-Brovarone, Chiara; Dunne, Nicholas
• Is Part Of: Medical engineering & physics. Volume 114(2023)
• Publication Date: 2023-04
• Subjects: Periprosthetic femoral fracture -- Osteoporosis -- Bone regeneration -- Finite element analysis -- Femur -- Fracture fixation assembly; Biomedical engineering -- Periodicals; Biomedical Engineering -- Periodicals; Physics -- Periodicals; Génie biomédical -- Périodiques; Biomedical engineering; Electronic journals; Periodicals; 610.28
• DOI: 10.1016/j.medengphy.2023.103967
• Languages: English
• ISSNs: 1350-4533

Abstract

Highlights: A novel advanced medicinal therapeutic device (AMTD) was designed and developed for the treatment of periprosthetic femoral fractures. Finite element analysis was carried out to investigate the effects of (i) physiological loading conditions; (ii) device-bone interface conditions; and (iii) fixation components' material properties on the stress-strain distributions within the AMTD and fracture fixation plate for osteoporotic fracture. Our results suggest that this novel AMTD combined with standard fixation solutions are capable of withstanding physiological loads and avoid mechanical failure. Abstract: The occurrence of periprosthetic femoral fractures (PFF) has increased in people with osteoporosis due to decreased bone density, poor bone quality, and stress shielding from prosthetic implants. PFF treatment in the elderly is a genuine concern for orthopaedic surgeons as no effective solution currently exists. Therefore, the goal of this study was to determine whether the design of a novel advanced medicinal therapeutic device (AMTD) manufactured from a polymeric blend in combination with a fracture fixation plate in the femur is capable of withstanding physiological loads without failure during the bone regenerative process. This was achieved by developing a finite element (FE) model of the AMTD together with a fracture fixation assembly, and a femur with an implanted femoral stem. The response of both normal and osteoporotic bone was investigated by implementing their respective material properties in the model. Physiological loading simulating the peak load during standing, walking, and stair climbing was investigated. The results showed that the fixation assembly was the prime load bearing component for this configuration of devices. Within the fixation assembly, the bone screws were found to have the highest stresses in the fixation assembly for all the loading conditions. Whereas the stresses within the AMTD were significantly below the maximum yield strength of the device's polymeric blend material. Furthermore, this study also investigated the performance of different fixation assembly materials and found Ti-6Al-4V to be the optimal material choice from those included in this study.