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2011, Copyright the Authors

Artificial Organs 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Optimization of the Femoral Stem of a Cemented Total

Hip Arthroplasty

*Toshimasa Ishida, *Ikuya Nishimura, Hiromasa Tanino, Masaru Higa, Hiroshi Ito, and

Yoshinori Mitamura

*Graduate School of Information Schience and Technology, Hokkaido University, Sapporo; Department of Orthopaedic

Surgery, Asahikawa Medical College, Asahikawa; Graduate School of Engineering, University of Hyogo, Himeji; and

School of Biological Science and Engineering, Tokai University, Sapporo, Japan

cemented total hip arthroplasty, and mechanical failure of

the stem is caused by several factors related to the cement,

such as failure of the cement. Optimization of the shape of

the stem, especially multiobjective optimization, is required

to solve these design problems because a cement fracture is

caused by multiple factors. The objective of this study was

to determine a stem geometry considering multiple factors

at the same time. A three-dimensional finite element model

of the proximal femur was developed from a composite

femur. A total of four objective functionstwo objective

functions, the largest maximum principal stress of proximal

and distal sections in the cement mantle, for each of the two

boundary conditions, walking and stair climbingwere

used. The neighborhood cultivation genetic algorithm was

results showed that the geometry that leads to a decrease in

the proximal cement stress and the geometry that leads to

a decrease in the distal cement stress were not the same.

However, the results of the walking and the stair climbing

conditions matched. Five dominant stem designs were considered to be the Pareto solution, and one design was identified as the better design for all objective functions. It

was shown that multiobjective optimization using a genetic

algorithm may be used for optimizing the shape of the

femoral stem in order to avoid cement fracture. Key

Words: Computer analysisFinite element analysis

OptimizationTotal hip replacementFemoral stem

Cement failure.

cemented total hip arthroplasty (THA) is often

attributed to failure of cement mantle associated with

many stress patterns in the cement (1).

There have been many changes in the design of the

femoral stem of THA, with many of these changes

being implicated in failure of the cement layer (2,3).

Many design and surgical factors may affect the

stress distribution related with aseptic loosening in

cemented femoral hip components (4,5). Therefore,

proper preclinical testing (6), including computer-

of implant loosening. For example, finite element

analysis (FEA), design sensitivity analysis (7), and

shape optimization have been used to evaluate and

create stem designs (811).

Although optimization is a suitable technique for

developing femoral stems, there were many limitations in optimization procedure. Huiskes and Boeklagen (8) and Yoon et al. (9) reported one of the

earliest optimization studies. However, simple twodimensional analysis models were used in both

reports because of lack of computer resources in the

1980s. A three-dimensional analysis cannot obtain

dramatic parameter changes; however, these analyses

are important because of the asymmetric femoral

geometry. Katoozian et al. (10) reported the relationship between objective functions, boundary conditions, and optimum geometries. These authors

doi:10.1111/j.1525-1594.2010.01117.x

Received June 2009; revised July 2010.

Address correspondence and reprint requests to Dr. Ikuya Nishimura, Graduate School of Information Science and Technology,

Hokkaido University, Kita 14 Nishi 9, Kita-ku, Sapporo, Hokkaido

060-0814, Japan. E-mail: mura@bme.ist.hokudai.ac.jp

404

aor_1117

404..410

concluded that different optimization conditions led

to different results. Thus, the use of multiple conditions and objective functions, called multiobjective

optimization, is one of the best methods for solving

complex optimization problems. Fernandes et al. (11)

analyzed the multiobjective optimization of a twodimensional cementless stem with a weighting

method. This method was useful in easily obtaining

the optimization direction. However, when there is a

large number of parameters or when detailed solutions are sought, the calculation time increased

greatly because of the increase in the number of

parameter combinations.

One way of overcoming all of these limitations is to

use a genetic algorithm (GA). GA is an algorithm for

solving large-scale optimization problems. Most of

the optimization algorithms consider only one solution, whereas GA considers many solutions as one

set and renews the solution sets during the

calculation. Therefore, a sufficient number of firstsolution parameters and renewal of solution sets can

easily solve large and complex problems.

The objective of this study was to optimize the

design of a cemented stem considering the several

simultaneous causes for cement failure. For this

purpose, GA was introduced in the optimization

calculation.

405

Modeling and design parameters

A three-dimensional finite element model of

the proximal femur was developed (Fig. 1). The

femoral geometry was determined on the basis of

the CAD data of the composite femur. Next, the

parametric stem model was developed using a CAD

program (Pro/Engineer, PTC, Inc.). The initial stem

shape was based on the results of our previous

study (12), and the 10 design parameters considered

were defined on the basis of the stem cross-sections

(Fig. 2). Later on, this initial model was used to

define the objective function. The design parameters

were defined as medial-lateral (ML) width and

anterior-posterior (AP) width of the stem proximal,

middle, and distal cross-sections. In particular, in the

case of the proximal sections, the ML width was

divided into two parameters considering the medial

and lateral sides along the stem neck axis. The stem

length was fixed at 140 mm and the head center

offset, at 38 mm.

All design parameters were labeled L1 to L10,

and the range of parameters is listed in Table 1.

These parameters are subjected to a set of constraints

Artif Organs, Vol. 35, No. 4, 2011

406

T. ISHIDA ET AL.

TABLE 1. Default values and the range of design

parameters used in stem CAD model

Proximal

ML

AP

Middle

ML

AP

Distal

ML

AP

L1

L2

L3

L4

L5

L6

L7

L8

L9

L10

Initial

Min

Max

8

14

6

6

12.6

6

6

8.8

3.5

3.5

6

12

4

4

10

4

4

6

2.5

2.5

21

15

6.5

6.5

13.6

6.5

6.5

9

4.5

4.5

decreased from the middle cross-section to the distal

cross-section,

g 1 = L5 L8 < 0

g 2 = L6 L9 < 0

g 3 = L7 L10 < 0.

After that, a cement mantle, with a constant thickness of 2 mm was added around the stem and a

mantle, 30-mm thick (1315), was added below the tip

of the stem. This model was fed into the FEA

program (ANSYS6.0, ANSYS, Inc., Cybernet

Systems Co. Ltd., Tokyo, Japan) in the IGES format.

Static stress analysis

The values of all objective functions were calculated using a static stress analysis. All analysis models

and design parameters were automatically constructed or determined by the optimization control-

comprised 11 792 8-noded brick elements and 12 667

nodes. The number of elements was the same for

all analysis models. The elastic modulii of the stem

material, bone cement (polymenthyl methacrylate

[PMMA]), cortical bone, and cancellous bone were

210, 2.2, 17, and 1 GPa, respectively (12). For each of

these materials, Poissons ratio was taken to be 0.3.

The cementbone interface was assumed to be fully

bonded. The cementstem interface was considered

to be a Coulomb frictional interface, with a coefficient of friction of 0.3 (16). We considered two

loading cases to simulate a physiological condition.

One corresponded to walking whereas the other corresponded to stair climbing. For both cases, the magnitudes and directions of the applied loads were

taken from the work of Stolk et al. (17).

Objective functions

A schematic presentation of the complete optimization procedure is shown in Fig. 3. Four objective

functions are used: the largest maximum principal

stresses of the distal (walk-distal; F1, stair-distal; F2)

and proximal (walk-proximal; F3, stair-proximal; F4)

part in the cement mantle. These objective functions

were defined on the basis of the results of the static

stress analysis of the initial model. Therefore, all optimization problems can be formulated as follows:

Minimize Fi ( x) i = 1 . . . 4

such that

407

(Lj)max are the upper and lower limits of the design

parameter xj.

GA parameter settings

The neighborhood cultivation genetic algorithm

(NCGA) (18) was introduced to minimize these

objective functions. NCGA is an example of a multiobjective GA and can optimize several objective

functions while maintaining the diversity of solutions.

The GA requires the encoding of design parameters

to bit strings in order to obtain the gene parameters.

In this study, it was mounted as follows:

1 Minimum value of a design parameter is defined as

000 . . . 0 on a gene parameter.

2 Maximum value is defined as 111 . . . 1.

3 A design parameter is encoded to the nearest bitstring area that is defined in (1) and (2).

A 10-bit string was used for defining the design

parameter used in this calculation. The population

size was set to 50 in a single generation, and the

number of generations was set to 20. Therefore, a

total of 1000 calculations were performed. During

each successive generation, 50% of the existing population was selected to determine the next generation

according to the fitness function. Double crossover

points on both parents organism strings were

selected. In NCGA, individuals who were close to

each other were chosen as the mated pair. Furthermore, mutation took place at a probability of 0.01 in

the case of all generations. After the analysis of each

generation, the values of objective functions were

plotted as a two-dimensional scatter chart.

RESULTS

Static stress analysis of pre-optimization

The distribution of the maximum principal stress

acting in the coronal midplane of the cement mantle

in the initial design is shown in Fig. 4. It was found

that the largest maximum principal stress in the

cement mantle was found near the tip of the stems for

both the walking (12.9 Mpa) and the stair-climbing

(15 Mpa) conditions, and another stress concentration was found in the proximal region of the cement

mantle. Note that these results were all bases of

objective functions.

Optimization and scatter diagram

Results of optimization are shown in Fig. 5. On all

charts, the direction of optimization is the lower left

one. On each diagram, each point has the following

properties:

case of the walking (a) and stair-climbing (b) conditions.

1 solution number;

2 value of all design parameters L1 . . . L10, and

value of objective functions F1 . . . F4;

3 where the solution number contains the generation

data.

Therefore, these charts provide the relationship

between the objective functions.

Stem design for each Pareto front

Several Pareto solutions are shown in Fig. 5 and

Table 2. Figure 5a shows the resulting Pareto solutions in the two-dimensional objective function

spaces. These solutions were based on an approximate trade-off line of two objective functions (F1

and F2). In this chart, the strongest geometry for the

proximal region is (1). At the same time, (1) is a

relatively worse geometry on the Pareto front for

the distal region. From this scatter chart (Fig. 5a),

five dominant designs were selected that were on

the Pareto front ([1][5]). Figure 5b shows the linearity of objective functions of F2 and F3. Clearly,

these two objective functions are correlated and not

a trade-off. Figure 5c also shows the trade-off line of

two objective functions (F3 and F4). Each number

in the figure represents the same design as that in

another figure.

DISCUSSION

This study was an initial attempt to use a GA for the

multiobjective optimization of the femoral stem of a

cemented THA. Compared with a mathematical

optimization method such as the steepest-descent

Artif Organs, Vol. 35, No. 4, 2011

408

T. ISHIDA ET AL.

optimization results. (a) The relationship

between walk-distal and walk-proximal, (b)

walk-distal and stair-distal, and (c) stairdistal and stair-proximal.

advantage for complex multiparameter analysis

because it searches the optimum values without using

a derivative function. Therefore, the GA will never

converge to a local extreme, and the solutions will

cover a wide range. Searching methods, however,

could not be used until recently, because the calculation time required to obtain good solutions was very

this study, a searching method required more than

2 months of CPU time to complete all the calculations

(Intel Xeon 2.4 GHz, Windows 2000 PC). An attraction of a searching method is that the individual calculation of each genetic parameter can easily be

carried out in parallel. Unlike in a mathematical optimization method, in a searching method, each gene

Proximal

ML

AP

Middle

ML

AP

Distal

ML

AP

Walk-distal (Mpa)

Walk-proximal (Mpa)

Stair-distal (Mpa)

Stair-proximal (Mpa)

L1

L2

L3

L4

L5

L6

L7

L8

L9

L10

(mm)

(mm)

(mm)

(mm)

(mm)

(mm)

(mm)

(mm)

(mm)

(mm)

(1)

(2)

(3)

(4)

(5)

8.47

14.7

5.28

6.33

13.1

6.18

5.95

8.77

3.24

2.54

12.4

10.93

12.43

4.81

6.2

13.46

5.15

6.27

6.6

4.07

2.78

12.2

18.61

14

5.1

5.1

13.2

6.47

4.63

6.66

3.3

2.66

9.3

19.45

14.73

5.12

6.39

13.48

6.31

4.67

6.6

3.43

2.55

8.6

19.45

13.99

5.78

6.42

10

6.32

4.66

6.1

3.55

2.51

7

3.3

12.8

4.9

3.5

13.7

5.4

3.7

10.6

7.6

3.8

9.9

5.5

4.9

8.5

7.5

parameter is independent from the others belonging

to the same generation. Thus, in this study, a 50-CPU

PC cluster was used to perform all calculations in less

than 2 days.

For general single objective optimization, the

optimal implant is only one particular case, the one

represented in the FE model. In most cases, because of

the variations in shape and properties, the optimal

implant will be suboptimal (19). Hence, a multiobjective approach was used for considering biomechanical

conditions.With respect to the Pareto solutions shown

in Fig. 5a, the geometries of (1) and (5) were the best

results for the two objective functions (Sp-walk and

Sd-walk). However, both geometries have a risk for

the other objective function. Therefore, geometries

(2), (3), and (4) were well balanced for the two objective functions. In contrast, in the case of the stairclimbing condition (Fig. 5c), (2) and (3) did not exist

on the Pareto front. Then, geometry (4) was the bestbalanced geometry for this analysis condition. Geometries (3) and (4) were almost the same except in the

case of the proximal cross-section. Therefore, the

dimensions of the stem of the proximal cross-section

should be carefully designed.

Resolution of the genetic parameter was one of the

important factors that affected the accuracy of the

solution. We used 10-bit strings as the genetic

parameters. The resolution of these strings was

approximately 1.5 10-2 mm in the case of the design

parameter L1 (15/210). These resolutions had to be

varied according to the accuracy of stem casting.

Low-resolution bit strings increase the calculation

speed but adversely affect the accuracy of the

solution. In the future work, the relationship between

the lengths of the genetic bit strings and the accuracy

of the solution has to be investigated.

From Fig. 5b, it is seen that the optimization direction of the two boundary conditions is the same. In

this study, the original values of all the loads were

obtained in an experimental study (20). In the case of

stair climbing, the load was higher than that in the

case of the walking condition for the purpose of

rotation. Therefore, the cement stress value in the

case of the stair-climbing condition was also higher

than that in the case of the walking condition, but the

tendency of results was the same in both cases. The

largest maximum principal stress value in the cement

mantle, which can lead to the fracture of the bulk of

the cement mantle, was higher in the case of the

stair-climbing condition than in the case of the

walking condition (Fig. 5). This tendency was

observed only in the proximal region. Therefore, the

stair-climbing condition was detrimental to the

cement around the proximal region. We suggest that

409

direction.

The main limitation of this study was that the

failure criteria related to the boundary conditions.

We used the largest maximum principal stress as the

objective function. In some clinical reports, it has

been suggested that the failure of the femoral stem is

attributable not only to the failure of the cement

mantle but also to the failure of the cementimplant

interface (21,22). Another limitation was the accuracy of the finite element method model. Most properties and model shapes were derived from our

previous study (12) as a continued work. Therefore,

the model in this study did not include the latest

methods in modeling and material properties. Considering these limitations, we can propose a new optimization method in a future work.

CONCLUSION

This study is the first report of the use of a genetic

algorithm for optimizing the shape of the femoral

stem in a cemented total hip arthroplasty. The optimized shape was obtained considering multiobjective

functions. This design is not the best design for all

objective functions, but it is better than the existing

designs for all conditions because of the trade-off

between the objective functions. Stem designers

should find the method presented in this study useful

when modifying the shape of the stem.

Acknowledgment: This research was partially

supported by Engineous Japan, Inc., Yokohama,

Japan.

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