Yufan Yan

Background: Total hip replacement replaces the femoral head, which cannot heal, with an artificial femoral shaft to ensure the patient’s normal life. However, due to the stress-masking effect of the proximal femur loaded with the artificial femur stem, the implant bears a large part of the load, resulting in insufficient stress stimulation of the proximal femur and bone waste remodeling. In turn, it is easy to lose bone, resulting in loosening. As a new treatment method, electrical stimulation has been widely used for bone loss, nonunion, and other diseases, and it has achieved good therapeutic effects. Methods: Therefore, in this work, electrical stimulation was introduced for postoperative density assessment, and a new disuse remodeling model was established to simulate density loss after remodeling and the resistance effect of electrical stimulation. The effects of various parameters on density loss in the model are discussed. Results: The simulation results revealed significant stress masking and density loss in the neck of the femur after hip replacement, and electrical stimulation placed in the neck of the femur may resist this density loss to a certain extent. The rate of bone mineral density reduction decreased after the addition of electrical stimulation, indicating that electrical stimulation can have a certain resistance to the density reduction caused by stress shielding, and this result is helpful for the rehabilitation of hip arthroplasty.

The fatigue damage behavior of bone has attracted significant attention in both the mechanical and orthopedic fields. However, due to the complex and hierarchical structure of bone, describing the damage process quantitively or qualitatively is still a significant challenge for researchers in this area. In this study, a nonlinear bi-modulus gradient model was proposed to quantify the neutral axis skewing under fatigue load in a four-point bending test. The digital image correlation technique was used to analyze the tensile and compressive strains during the fatigue process. The results showed that the compressive strain demonstrated an obvious two-stage ascending behavior, whereas the tensile strain revealed a slow upward progression during the fatigue process. Subsequently, a theoretical model was proposed to describe the degradation process of the elastic modulus and the movement of the neutral axis. The changes in the bone properties were determined using the FEM method based on the newly developed model. The results obtained from two different methods exhibited a good degree of consistency. The results obtained in this study are of help in terms of effectively exploring the damage evolution of the bone materials.