title: Mechanical simulation of muscle loading on the proximal femur: analysis of cemented femoral component migration with and without muscle loading.
abstract: OBJECTIVE
  This study examines the effect of including muscle forces in fatigue tests of cemented total hip arthroplasty reconstructions.
  
  
  METHODS
  An experimental device capable of applying the joint reaction force, the abductor force, the vastus lateralis force, and the tensor fasciae latae force to the implanted femur is described.
  
  
  BACKGROUND
  Current in vitro fatigue tests of cemented total hip arthroplasty reconstructions do not apply physiological muscle loads. Experimental and numerical studies report significant differences in stresses obtained in the cement mantle depending on the loads applied. The differing stresses may alter the outcome of an in vitro test.
  
  
  METHODS
  Ten femoral components were reproducibly implanted into proximal composite femurs. Five of these femoral components were tested using a loadprofile which included muscle loading, five were tested without muscle loading. The migration of each femoral component was monitored continuously during dynamic fatigue tests.
  
  
  RESULTS
  Clinically comparable migration amounts were found for both sets of femoral components, with the femoral components tested with muscle loading experiencing lower mean migration, lower mean inducible displacement, and less experimental scatter.
  
  
  CONCLUSIONS
  The inclusion of muscle forces seems to stabilise the femoral component during the test. In vitro fatigue tests of cemented total hip arthroplasty reconstructions should include muscle loading to provide increased confidence in the results obtained.
  
  
  CONCLUSIONS
  This study examines how the migration of cemented femoral hip prostheses is influenced by muscle forces. Hip prostheses are one of the few medical devices for which pre-clinical testing protocols have emerged, and this study ascertains whether or not the inclusion of muscle forces is necessary for pre-clinical tests. The conclusion that muscle loading should be included, and that it is important for the development of a new generation of standardised tests to provide enhanced patient protection against functionally poor prostheses.
authors.affiliation: Centre for Bioengineering, Department of Mechanical Engineering, Trinity College, Dublin 2, Ireland.
authors.forename: J R
authors.initials: JR
authors.lastname: Britton
authors.forename: L A
authors.initials: LA
authors.lastname: Walsh
authors.forename: P J
authors.initials: PJ
authors.lastname: Prendergast
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods; D002484:Cementation / Q000379:methods*; D003198:Computer Simulation; D004867:Equipment Design; D019544:Equipment Failure Analysis / Q000295:instrumentation* / Q000379:methods*; D005270:Femur Head / Q000503:physiopathology* / Q000601:surgery; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D007593:Joint Instability / Q000503:physiopathology* / Q000517:prevention & control / Q000601:surgery; D008954:Models, Biological; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology; D010812:Physical Stimulation / Q000295:instrumentation / Q000379:methods; D011474:Prosthesis Design / Q000295:instrumentation / Q000379:methods; D011475:Prosthesis Failure; D016474:Weight-Bearing