Development of in vitro methods to test acetabular prosthetic reconstructions (messa a punto di metodi in vitro per la caratterizzazione biomeccanica di ricostruzioni acetabolari)

The revision hip arthroplasty is a surgical procedure, consisting in the reconstruction of the hip joint through the replacement of the damaged hip prosthesis. Several factors may give raise to the failure of the artificial device: aseptic loosening, infection and dislocation represent the principal causes of failure worldwide. The main effect is the raise of bone defects in the region closest to the prosthesis that weaken the bone structure for the biological fixation of the new artificial hip. For this reason bone reconstruction is necessary before the surgical revision operation. This work is born by the necessity to test the effects of bone reconstruction due to particular bone defects in the acetabulum, after the hip prosthesis revision. In order to perform biomechanical in vitro tests on hip prosthesis implanted in human pelvis or hemipelvis a practical definition of a reference frame for these kind of bone specimens is required. The aim of the current study is to create a repeatable protocol to align hemipelvic samples in the testing machine, that relies on a reference system based on anatomical landmarks on the human pelvis. In chapter 1 a general overview of the human pelvic bone is presented: anatomy, bone structure, loads and the principal devices for hip joint replacement. The purpose of chapters 2 is to identify the most common causes of the revision hip arthroplasty, analysing data from the most reliable orthopaedic registries in the world. Chapter 3 presents an overview of the most used classifications for acetabular bone defects and fractures and the most common techniques for acetabular and bone reconstruction. After a critical review of the scientific literature about reference frames for human pelvis, in chapter 4, the definition of a new reference frame is proposed. Based on this reference frame, the alignment protocol for the human hemipelvis is presented as well as the statistical analysis that confirm the good repeatability of the method.

Micro-FEM models based on micro-CT reconstructions for the in vitro characterization of the elastic properties of trabecular bone tissue.

This master’s thesis describes the research done at the Medical Technology Laboratory (LTM) of the Rizzoli Orthopedic Institute (IOR, Bologna, Italy), which focused on the characterization of the elastic properties of the trabecular bone tissue, starting from october 2012 to present. The approach uses computed microtomography to characterize the architecture of trabecular bone specimens. With the information obtained from the scanner, specimen-specific models of trabecular bone are generated for the solution with the Finite Element Method (FEM). Along with the FEM modelling, mechanical tests are performed over the same reconstructed bone portions. From the linear-elastic stage of mechanical tests presented by experimental results, it is possible to estimate the mechanical properties of the trabecular bone tissue. After a brief introduction on the biomechanics of the trabecular bone (chapter 1) and on the characterization of the mechanics of its tissue using FEM models (chapter 2), the reliability analysis of an experimental procedure is explained (chapter 3), based on the high-scalable numerical solver ParFE. In chapter 4, the sensitivity analyses on two different parameters for micro-FEM model’s reconstruction are presented. Once the reliability of the modeling strategy has been shown, a recent layout for experimental test, developed in LTM, is presented (chapter 5). Moreover, the results of the application of the new layout are discussed, with a stress on the difficulties connected to it and observed during the tests. Finally, a prototype experimental layout for the measure of deformations in trabecular bone specimens is presented (chapter 6). This procedure is based on the Digital Image Correlation method and is currently under development in LTM.