ArticleJournal of orthopaedic surgery and research2025
Femoral fracture risk in transfemoral amputees with bone-anchored prosthetic limbs during activities of daily living.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- An Optimization Method for an Active Multi-Unit Prosthetic Socket with Dynamic Adaptability in Multi-Task Scenarios.Biomimetics (Basel, Switzerland) · 2026Article
- Evidence-informed methodological approaches for coupled neuromusculoskeletal-finite element analysis workflows in orthopaedic biomechanics.Frontiers in bioengineering and biotechnology · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundBone-anchored prostheses (BAPs) address many of the shortcomings of socket prostheses, driving the adoption of the technology for lower limb amputees. However, higher femoral fracture rates have been observed in these patients compared to socket users. It is believed that this increased fracture rate is due to the direct transmission of loads to bone through the bone-anchored implant. While low-impact activities, such as walking, have been extensively studied using finite element (FE) models, other more demanding low-impact activities such as ambulating on stairs and inclines remain poorly understood. Most previously reported subject-specific FE models of femurs fitted with osseointegrated implants were not validated against experimental data. The current study aimed to validate an FE modelling methodology using implanted cadaveric specimens and to calculate the fracture risk of implanted femurs during various activities of daily living.
methodStrain responses of cadaveric femurs fitted with press-fit osseointegrated implants under load were recorded and compared to strain predicted by specimen-specific FE models created from CT data. Five different published relationships between Hounsfield units and Young's Moduli were investigated to determine which relationship gave the most accurate model predictions. The validated FE models of the implanted femurs were later used to simulate in-vivo force measurements during five routine activities of daily living. Lastly, the fracture risk of the implanted femurs during these activities was quantified using factor of safety (FOS), where FOS = 1 denoted fracture was predicted at the given load.
resultsThe validated FE model predicted the experimental strain responses with a coefficient of determination (R
conclusionMale BAP FE models predicted the experimental bone strains and suggested that peak loads during ambulation on level ground, stairs, and inclines are unlikely to cause bone fracture.
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Registered trials
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