Abstract

In the last two decades, osseointegrated prostheses have been shown to be a good alternative for lower limb amputees experiencing complications in using a traditional socket-type prosthesis; however, restraining biomechanical issues, such as peri-prosthetic bone fractures or loosening, are present. To better understand and overcome these limiting issues, and thus reduce the number of implant failures, many studies have investigated the stress distribution on bone and implant during normal daily activities. The aim of this study was a biomechanical analysis of two different osseointegrated implants, a screw-type (OPRA) and a press fit system (OPL, Osseointegrated Prosthetic Limb), to evaluate the stresses generated in bone and prosthesis during a fall. In particular, four scenarios have been experimentally reproduced to determine the loads on the limb during different kinds of fall. For this purpose, a motion capture system and a force plate have been used. Numerical FEM (Finite Element Method) simulations have been performed to compare the behaviour of the OPRA and OPL systems in different fall scenarios. The obtained results showed that a fall backwards due to balance loss is the most stressful scenario among the ones analysed. As regards the comparison between OPRA and OPL devices, it emerged they have similar behaviours in terms of peak values of the stress, but the OPL implant generates larger high-stress areas in the distal femur as compared with the OPRA system.

Highlights

  • Two main prosthetic systems are mainly used to treat transfemoral amputees: the socket-type prosthesis and the OsseoIntegrated (OI) prosthesis

  • Two main designs are available for OI transfemoral prostheses: the screw-fixation type and the press-fit one. Both systems are composed of an intramedullary stem and a coupling device which passes through the soft tissues of the stump to link with the artificial limb [18,19,20]

  • Mises stress on the bone during the falls

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Summary

Introduction

Two main prosthetic systems are mainly used to treat transfemoral amputees: the socket-type prosthesis and the OsseoIntegrated (OI) prosthesis. Two main designs are available for OI transfemoral prostheses: the screw-fixation type and the press-fit one Both systems are composed of an intramedullary stem (fixture) and a coupling device (abutment) which passes through the soft tissues of the stump to link with the artificial limb [18,19,20]. The healing period varies depending on the type of implant: about 6–8 weeks for the press-fit systems and up to 6 months for the OPRA implants [25,26] In both cases, after the fixture implantation, the bone–implant interface is irregular and consists of regions with gaps between the bone and the stem and regions of direct contact between the bone and the implant [27].

Experimental
Marker-set
Subject
CAD models of the prosthetic implants analysed
Data Post Processing
Loads during Falls
59 Figure 9 49
Discussion
Full Text
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