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osthesis (right hand side).
Compared to the physiological flexural stresses in the diaphysis of the sound femur, the prosthesized femur induces a concentration in the medial region while they are completely absent in the proximal end. This occurrence is referred as “stress shielding effect” and it is due to the high rigidity of the metal prosthesis stem that does not allow the physiological flexure of diaphysis.
The absence of stress (and related strains state) could induce, over the time, significant bone structure modification (bone reabsorption).
Bone modeling and remodeling processes, in fact Xander Bogaerts Nike Jersey , enable itself to grow, renew, and repair itself (Gottesman and Hashin, 1980; Huiskes et al., 1987; Taylor et al. David Ortiz Nike Jersey , 2007; Weinans et al., 1992). Mechanical adaptation of trabecular density and architecture could be explained in terms of mechano-sensory and signaling functions for the osteocytes (Mullender and Huiskes, 1995). Mechanic-regulation mechanism driving bone remodeling uses mechanical strain and micro-damage as the stimulus driving cellular responses and the consequent changes in the bone density and geometry. The absence or the modification of the biomechanical stimuli shown in figure 10 for the femur diaphysis after prosthesis implantation is then expected to lead, over the time, to a bone remodeling and reabsorption due to the absence of an adequate stress and strain state.
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Conclusions
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聽Results of our biofidel modeling of the sound and prosthesized bone would clarify the level of complexity needed when computing the strain state of a human femur through FEA when the stress and strain state has to be used to quantify the bone remodeling process.
A faithful bone models allows the accurate choice of the femur locations where the hypothesis of isotropic conditions (diaphysis) can be made and the femur locations where the bone orthotropy hypothesis should be applied (proximal end epiphysis). The distribution of maximum strain is correctly described by our theoretical approach since can envisage the location of the pertrochanteric fracture. The model can be usefully applied in those cases where the strain distributions need to be evaluated in order to predict undesired bone remodeling processes.
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