How accurately do finite element models predict the fall impact response of ex vivo specimens augmented by prophylactic intramedullary nailing?

IF 2.1 3区 医学 Q2 ORTHOPEDICS
Emily K Bliven, Anita Fung, Alexander Baker, Ingmar Fleps, Stephen J Ferguson, Pierre Guy, Benedikt Helgason, Peter A Cripton
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Abstract

Hip fracture prevention approaches like prophylactic augmentation devices have been proposed to strengthen the femur and prevent hip fracture in a fall scenario. The aim of this study was to validate the finite element model (FEM) of specimens augmented by prophylactic intramedullary nailing in a simulated sideways fall impact against ex vivo experimental data. A dynamic inertia-driven sideways fall simulator was used to test six cadaveric specimens (3 females, 3 males, age 63-83 years) prophylactically implanted with an intramedullary nailing system used to augment the femur. Impact force measurements, pelvic deformation, effective pelvic stiffness, and fracture outcomes were compared between the ex vivo experiments and the FEMs. The FEMs over-predicted the effective pelvic stiffness for most specimens and showed variability in terms of under- and over-predicting peak impact force and pelvis compression depending on the specimen. A significant correlation was found for time to peak impact force when comparing ex vivo and FEM data. No femoral fractures were found in the ex vivo experiments, but two specimens sustained pelvic fractures. These two pelvis fractures were correctly identified by the FEMs, but the FEMs made three additional false-positive fracture identifications. These validation results highlight current limitations of these sideways fall impact models specific to the inclusion of an orthopaedic implant. These FEMs present a conservative strategy for fracture prediction in future applications. Further evaluation of the modelling approaches used for the bone-implant interface is recommended for modelling augmented specimens, alongside the importance of maintaining well-controlled experimental conditions.

有限元模型如何准确预测通过预防性髓内钉加固的体外标本的跌落冲击响应?
有人提出了预防性髋部骨折的方法,例如使用预防性髓内钉加固装置来加固股骨,防止在跌倒情况下发生髋部骨折。本研究的目的是根据体内外实验数据,验证通过预防性髓内钉增强的标本在模拟侧向跌落冲击中的有限元模型(FEM)。我们使用惯性驱动的动态侧向跌落模拟器测试了六个预防性植入髓内钉系统以增强股骨的尸体标本(3 女 3 男,年龄 63-83 岁)。对活体实验和有限元模型之间的冲击力测量、骨盆变形、有效骨盆刚度和骨折结果进行了比较。有限元模型对大多数试样的有效骨盆刚度预测过高,并且根据试样的不同,对冲击力峰值和骨盆压缩的预测存在偏低和偏高的差异。在比较体外数据和有限元数据时,发现冲击力达到峰值的时间具有明显的相关性。在体外实验中没有发现股骨骨折,但有两个试样骨盆骨折。有限元模型正确识别了这两处骨盆骨折,但有限元模型还对另外三处骨折进行了假阳性识别。这些验证结果凸显了这些侧向跌落撞击模型目前在包含骨科植入物方面的局限性。这些有限元模型为未来应用中的骨折预测提供了一种保守策略。建议对骨-植入物界面的建模方法进行进一步评估,以建立增强试样模型,同时必须保持良好的实验条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Research®
Journal of Orthopaedic Research® 医学-整形外科
CiteScore
6.10
自引率
3.60%
发文量
261
审稿时长
3-6 weeks
期刊介绍: The Journal of Orthopaedic Research is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.
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