Adaptive glenoid bone remodeling simulation.
Glenoid prosthesis loosening is the most common cause for revision total shoulder arthroplasty. Stress-induced bone remodeling may compromise long-term prosthesis fixation and significantly contribute to loosening. Realistic, robust analysis of bone-prosthesis constructs need to look beyond initial post-implantation mechanics provided by static finite element (FE) simulation. Adaptive bone remodeling simulations based on Wolff's law are needed for evaluating long-term glenoid prostheses fixation. The purpose of this study was to take a first step towards this goal and create and validate two-dimensional FE simulations, using the intact glenoid, for computing subject-specific adaptive glenoid remodeling. Two-dimensional glenoid FE models were created from scapulae computed tomography images. Two distinct processes, "element" and "node" simulations, used the forward-Euler method to compute bone remodeling. Initial bone density was homogeneous. Center and offset load combinations were iteratively applied. To validate the simulations we performed location-specific statistical comparisons between predicted and actual bone density, load combinations, and "element" and "node" processes. Visually and quantitatively "element" simulations produced better results (p>0.22), and correlation coefficients ranged 0.51-0.69 (p<0.001). Having met this initial work's goals, we expect subject-specific FE glenoid bone remodeling simulations together with static FE stress analyses to be effective tools for designing and evaluating glenoid prostheses.
Sharma
Gulshan B
GB
University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213, USA; University of Calgary, Schulich School of Engineering, Department of Civil Engineering, Calgary, Alberta T2N 1N4, Canada.
Debski
Richard E
RE
University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213, USA.
McMahon
Patrick J
PJ
University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213, USA.
Robertson
Douglas D
DD
University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213, USA; Carnegie Mellon University, Cylab, Pittsburgh, Pennsylvania 15213, USA. Electronic address: ddr2@pitt.edu.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001696:Biomechanical Phenomena; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D008954:Models, Biological; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012540:Scapula / Q000033:anatomy & histology* / Q000502:physiology* / Q000601:surgery; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery