Abstract
Presently, total joint replacement (TJR) is a standard procedure in orthopedic surgery. Adequate osseointegration of the implant components still remains a clinical issue. However, active stimulation of bone tissue to enhance bone ongrowth at the implant surfaces has not been widely investigated so far. For the last several years, invasive electromagnetically induced osseotherapy has been employed in clinical practice, e.g., for the treatment of avascular necrosis, femoral neck fractures, and pseudarthrosis. In the present study, the approach of exploiting the electric stimulation effect was transferred to the field of TJR. Therefore, a commercially available total hip stem was instrumented with an electrode on its surface in order to generate an electric field supporting the regeneration of the surrounding bone tissue. The objective was to conduct numerical simulations validated by experimental investigations as a proof of concept for an instrumented electro-stimulative total hip stem. The results revealed that the calculated electric field around a total hip stem fulfills the requirements to stimulate adjacent bone tissue when using clinically applied electric voltages. The derived numerical and experimental data of electric potentials and corresponding electric fields are encouraging for the implementation of active electrical stimulation in uncemented total hip stems to enhance their osseointegration.
Highlights
An alternative for the enhancement of bone ongrowth and stable implant fixation may be the application of electrical stimulation of the adjacent bone tissue
In clinical practice, invasive electromagnetically induced osseotherapy has been used for the stimulation of osseoinduction in cases of avascular femoral head necrosis, femoral neck fractures, and pseudarthrosis [4,5]
As in a homogeneous medium the electric potential proportional withproportional the distance with from the the electrode, it could roughlyitexpected meavaries inversely distance from the be electrode, could bethat roughly surements on line starting from the interface between the implant and the insulator expected that measurements on line B starting from the interface between the implant resulted in smallerresulted values of potential than measurements on measurements line A starting from the and the insulator in the smaller values of the potential than on line
Summary
In clinical practice, invasive electromagnetically induced osseotherapy has been used for the stimulation of osseoinduction in cases of avascular femoral head necrosis, femoral neck fractures, and pseudarthrosis [4,5]. In this therapeutic approach, based on Kraus and Lechner’s [6] work, patients are instrumented with a bipolar induction screw implant such as the Asnis III s-series screw, (Stryker Trauma, Kiel, Germany), which consists of two electrodes and a secondary coil [4].
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