Developing porous hip implants implementing topology optimization based on the bone remodelling model and fatigue failure

In contemporary orthopaedic practice, total hip arthroplasty (THA) is a reliable surgical technique for hip joint replacement. However, introducing solid implants into human bone tissue can lead to complications, notably stress shielding and cortical hypertrophy. These issues often stem from mechanical mismatches, particularly stiffness disparities, between the solid implants and the bone tissue. A potential solution lies in adopting porous implant structures with lower stiffness and tuneable mechanical properties based on morphological parameters such as porosity, relative density, and unit cell sizes. This study, which is of significant importance to orthopaedic implant development, aims to develop porous implants that meet biological and manufacturing requirements, employing topology optimization methods to address the challenges associated with conventional solid implants. To achieve this objective, we conducted finite element analyses to compare the stress distribution within healthy bones with solid and newly developed porous implants under real-life loading conditions. The porous implants were designed with triply periodic minimal surface structures, featuring uniform relative density and gradient relative density mapping derived from topology optimization results considering additive manufacturing capabilities and biological constraints. Our findings provide critical insights into the impact on the bone's mechanical environment about the choice of implant. Specifically, solid implants significantly decrease applied stress within the cortical bone, leading to stress shielding and subsequent bone resorption, consistent with bone remodelling principles and Wolff's law. However, replacing the solid implant with uniform porosity with maximum compliance and employing gradient porous implants based on topology optimization methods significantly increases the strain energy density ratio. Specifically, the uniform gyroid, uniform diamond, gradient gyroid, and gradient diamond stems exhibited increases of 43%, 39%, 27%, and 25%, respectively, compared to the solid stem, effectively mitigating the stress shielding effect. However, amongst porous stems, only gradient designs could meet the mechanical strength requirements with a safety factor greater than one, rendering them suitable replacements for solid implants aimed at addressing associated complications. These results hold promise, particularly with the advancements in additive manufacturing methods capable of fabricating these porous implants with acceptable precision.