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|title: ||Biomechanical analysis of total elbow replacement with unlinked iBP prosthesis: an in vitro and finite element analysis|
|authors: ||Completo, A.|
|keywords: ||Instrumented Bone Preserving|
Unlinked elbow prosthesis
Finite element models
|issue date: ||2011|
|abstract: ||Background: Numerous models of elbow prostheses are being used and can be divided into two categories:
one being a semi-constrained, linked type; and the other being non-constrained, unlinked type. Recent
reports of National Elbow Arthroplasty Registers reveal no significant differences in the survival rates
between linked and unlinked prosthesis brands, and the main cause appointed for revision for both types is
loosening. Some previous biomechanical studies confirm the presence of abnormal bone stresses for the
linked type, which can be associated with the risk of loosening. However for the unlinked type, biomechanical
studies are not available that corroborate a loosening risk. It seems, that issue has not yet been fully answered
and requires further analysis.
Methods: Cortex strains adjacent to the elbow joint were measured with strain gauges in synthetic humeri and
ulnae, before and after replacement. To assess cancellous bone strains and cement stresses around the implant
finite element models validated relative to measured strains were used.
Findings: Bone strains adjacent to the implant tip increased several times in the humerus and ulna. At the
epiphyseal regions a generalised cancellous bone strain reduction was observed for both humerus and ulna
relatively to the intact bones.
Interpretation: The unlinked elbow prostheses can be associated with the risk of bone fatigue failure by
overload, particularly in the ulna, and bone resorption by stress-shielding at the epiphyseal regions. The
identical structural behaviour relative to linked prostheses associated with the same loosening risks
corroborates the results of recent arthroplasty published register reports.|
|publisher version/DOI: ||http://dx.doi.org/10.1016/j.clinbiomech.2011.06.008|
|source: ||Clinical Biomechanics|
|appears in collections||MEC - Artigos|
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