Total hip arthroplasty (THA) is a routine procedure for the treatment of advanced hip joint damage. The long-term result of the prosthesis is mainly determined by migration or aseptic loosening caused by bone remodelling. Especially the migration of the artificial hip cup as a consequence of the remodelling process is a major problem. Patient-specific hip cups can be used to counteract this. However, individual hip cups are currently only implanted for the treatment of great deformations or tumours in the hip joint due to the cost-intensive manufacturing. The aim of this project is the development and establishment of a concept for the economical production of patient-individual prosthetic hip cups out of titanium sheets. This process consists of two steps. First, undersized cups of a universal acetabulum geometry are produced. In the second step a true-to-size enlargement of the produced universal cup prothesis is carried out by means of a modified adaptive rubber-die forming process. The development of this process is accompanied by a simulationbased planning of the production process as well as by a realization of a metal forming adapted design method. For the examination of the feasibility of the concept, CT-data of canine pelvis geoemtries are used because of the large number of CT data, which were aviable for the project. Furthermore it is planned, that the first manufactured prototypes will be tested using canine cadaver. In this study the planning of the manufacturing of the standardized titanium sheet metal components is carried out. For this two methods of producing the standardized hip cup were compared. The first method is a hydraulic forming; the second is a normal pressing process with a bunch die and a binder. Pure titanium was introduced in the simulation, which shows the same mechnical properties like the in prosthetics normally used titanium alloy TiAl6V5. The results of the process simulation of both methods showed that the reducing of the blank thickness is a problem of the manufacturing of the prosthesis. Because of that an adaption of the tool geometry was executed and the influence of the increase of the forming temperature at 200 C was examined. These simulations indicated, that the hydraulic forming seems to be a convenient method to produce the prosthetic acetabulum. The first part of the metal forming adapted design method is the deduction of a universal acetabulum geometry, which has to be designed for the production of the standardized component. This deduction shall be realized by means of a superposition of 3D models of pelvis geometries. For this, two different superposition methods were compared and the Best Fit method was determined as the suitable method. By means of the Best fit method a first universal geometry was created.

BACKGROUND Numerous short stemmed total hip arthroplasty (THA) implants have been introduced over the last decades. It is questionable if little differences between the implant designs affect stress shielding and bone remodeling. The finite element analysis allows an evaluation of the design rationale of the implant without negative side effects for the patient. OBJECTIVE We investigated a relatively new short stemmed implant designed from clustered CT datasets of proximal femurs. How does the implant affect femoral bone remodeling? Can we see a positive effect on bone remodeling from the CT based design? METHODS We used a Finite Element Model that was validated by a prospective dual-energy-x-ray-absorptiometry study to calculate apparent bone density. RESULTS Apparent bone density (ABD) decreased by 2.3% in the entire femur. Bone mass loss was pronounced in the proximal calcar region. Little ABD increase was seen in the lateral aspect of the cortical ring, in the minor trochanter area and at the lateral aspect of the stem. CONCLUSIONS ABD reduction occurs in the proximal regions of the femur. The overall bone mass loss was little after THA with the investigated implant. The specific design seems to have no major effect on stress shielding or load distribution.

Total hip replacement (THR) is a routine procedure mostly used for the treatment of primary osteoarthrosis of the hip joint. Despite good clinical results aseptic loosening caused by strain-adaptive remodeling processes of bone tissue is the main cause for failure of the implant. As a consequence the migration of the cup can be significant [1].The presented study is an extension of our previous research work, where remodeling processes were already calculated in the prosthetic pelvis using a static load case [2]. In the present study the same finite element (FE) model has been used but the hip joint forces were derived from the multi-body simulation (MBS) of the gait cycle of a human test subject with normal walking speed. Hence, a more realistic load case is used which is supposed to affect the simulation result. This is due to our investigations in the femur [3], where a significant different simulation result for the bone mass loss has been computed comparing static load cases and the more realistic loads applied from a study of Bergmann et al. [4].The comparison of the simulation result of the static and the dynamic load cases confirms the assumptions of a lower decrease of the average bone density in the pelvis with the dynamic load case. Furthermore, a variation in the resorption area is determined as well. On the basis of the final density distribution in the acetabulum the loading situation of a migrated prosthesis should be determined with the MBS model to estimate the influence of the cup position on the hip resultant.

Bone remodeling after total ankle replacement (TAR) is a serious problem concerning the long term stability of the implant. With the help of the finite element method (FEM) remodeling processes after TAR have been calculated for the tibia and the talus. The results may be useful to optimize the implant design and to contribute to the longevity of TAR.

In total hip arthroplasty (THA), short stemmed cementless implants are used because they are thought to stimulate physiological bone remodeling and reduce stress shielding. We performed a numerical investigation on bone remodeling after implantation of a specific short stemmed implant using finite element analysis (FEA). Overall bone mass loss was 2.8% in the entire femur. Bone mass decrease was mostly found in the proximal part of the calcar and in the greater trochanter due to the vast cross section of the implant, probably leading to stress shielding. In the diaphysis, no change in the apparent bone density was proven. The assumptions made agreed well with bone remodeling data from THA recipients who underwent dual‐energy X‐ray absorptiometry. However, the clinical investigation revealed a bone mass increase in the minor trochanter region that was less pronounced in the FEA. Further comparisons to other stem designs must be done to verify if the relative advantages of the investigated implant can be accepted. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1822–1829, 2012

BACKGROUND:The use of artificial endoprostheses has become a routine procedure for knee and hip joints while ankle arthritis has traditionally been treated by means of arthrodesis. Due to its advantages, the implantation of endoprostheses is constantly increasing. While finite element analyses (FEA) of strain-adaptive bone remodelling have been carried out for the hip joint in previous studies, to our knowledge there are no investigations that have considered remodelling processes of the ankle joint. In order to evaluate and optimise new generation implants of the ankle joint, as well as to gain additional knowledge regarding the biomechanics, strain-adaptive bone remodelling has been calculated separately for the tibia and the talus after providing them with an implant.METHODS:FE models of the bone-implant assembly for both the tibia and the talus have been developed. Bone characteristics such as the density distribution have been applied corresponding to CT scans. A force of 5,200 N, which corresponds to the compression force during normal walking of a person with a weight of 100 kg according to Stauffer et al., has been used in the simulation. The bone adaptation law, previously developed by our research team, has been used for the calculation of the remodelling processes.RESULTS:A total bone mass loss of 2% in the tibia and 13% in the talus was calculated. The greater decline of density in the talus is due to its smaller size compared to the relatively large implant dimensions causing remodelling processes in the whole bone tissue. In the tibia, bone remodelling processes are only calculated in areas adjacent to the implant. Thus, a smaller bone mass loss than in the talus can be expected. There is a high agreement between the simulation results in the distal tibia and the literature regarding.CONCLUSIONS:In this study, strain-adaptive bone remodelling processes are simulated using the FE method. The results contribute to a better understanding of the biomechanical behaviour of the ankle joint and hence are useful for the optimisation of the implant geometry in the future.