Background: Osseointegrated prostheses (OIP) use is increasing for above-knee amputees who have difficulties with sockets. This study aims to simulate the bone-implant interface under loading using a 3D finite element (FE) model and quantify force distribution to produce hypotheses on bone remodelling and implant failure, informing implant and surgical design, and rehabilitation protocols.
Methods: Ten customised 3D femur FE models (5 female, 5 male) were generated from CT scans and bone-implant assemblies created. The bone was subdivided into seven Gruen Zones and four proximal femur regions. Boundary conditions were taken from the literature.
Results: The highest stresses were found in the implant (Max: 113.9 MPa), whilst highest strains were seen in the bone (Max: 4.89 %). Stress and strain were unevenly distributed, with distal regions experiencing stress shielding effects and areas around the implant tip experiencing significantly higher stresses and strains (p < .001). Maximum stresses were higher in female bones (p < .01), whilst shorter residuum lengths saw significantly lower stresses (p < .05).
Conclusion: Sex, size and limb length are all important factors and these need to be accounted for when designing and implanting OIPs.
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