A biomechanical regulatory model for periprosthetic fibrous-tissue differentiation.

Loosening of implants in bone is commonly associated with a development of fibrous interface tissues, due to interface gaps and a lack of mechanical stability. It has been postulated that the differentiation of these tissues to fibrocartilage or bone is governed by mechanical stimuli. The objective of our research is to unravel these relationships to the extent that the question whether an implant will loosen can be answered from initial conditions determined by implant and interface morphology, and functional loads. In this project we studied the hypothesis that distortional strain and interstitial fluid flow are the mechanical stimuli governing tissue differentiation. For that purpose, a biomechanical regulatory model was developed and used in association with a finite element code to simulate animal experiments with implants moving in bone. The similarities between the implant incorporation process found in the experiment and its simulation with the computer model demonstrate that our hypothesis is viable from a regulatory point of view.