Study of Stress Distribution in Press-Fit Transfemoral Implants: Standard Versus Patient-Specific Design

Abstract

Osseointegrated implant is a promising solution for limb amputations, but its widespread use is limited by risks such as bone resorption, infections, and strict patient requirements. Typically, the bone and prosthesis are coupled using a press-fit condition, providing short-term stability, or primary stability (PS), which leads to bone in-growth and long-term stability, or secondary stability (SS). However, the greater stiffness of the implant compared to the bone is a concern for SS. Currently, osseointegrated implants are commercially available only in fixed configurations, with a limited use of customization. This study aims to compare the contact effectiveness of three press-fitted intramedullary stems for femoral amputations, developed using three designs (straight, standard curvature, and patientspecific curvature). Moreover, a novel implant design methodology is reported, such is an easy way to develop a patient-specific design. The von Mises stress distribution at the bone-implant interface was analyzed. The study uses CAD models of a femur acquired through CT scans. A FEA was conducted to evaluate the elastic behavior of the bone when the implant is press-fitted with an interference of 0.1 mm. The outcomes show how the patient-specific implant result in a more physiological distribution of the load in the bone. This study could be used as a starting point for further studies on primary and secondary stabilities.