Stiffness analysis of tibia-implant system under cyclic loading

A testing method has been developed to characterize stiffness and permanent deformation of bone-implant systems. The system consists of an artificial tibia with simulated distal fracture stabilized by an unreamed intramedullary nail. This system was loaded with three different sequences at 2 Hz, each consisting of 40,000 sinusoidal cycles, simulating clinical relevant loading conditions. Evaluation of the results showed a stiffness of 2782 N/mm with a standard deviation of 311 N/mm and a permanent deformation of 0.64 mm with a standard deviation of 0.21 mm. The locking screws broke exclusively during the third loading sequence starting with the most proximal of the distal screws. The study provides a standard technique for biomechanical testing and a comparison of different bone/implant-systems avoiding the variability of cadaver bone tests.