INTERNATIONAL CONGRESS ON COMPUTATIONAL BIOENGINEERING
M. Doblar , M. Cerrolaza and H. Rodrigues (Eds.)
VALIDATION OF A GRADED CONTROLLED STIFFNESS FEMORAL
STEM CONCEPT
J. A. Simes1, J. Monteiro2, M. A. Vaz2
1
Departamento de Engenharia Mecnica
Universidade de Aveiro, Portugal
2
Departamento de Engenharia Mecnica e Gesto Industrial
Faculdade de Engenharia da Universidade do Porto, Portugal
ABSTRACT
The aim of this paper is to describe a method to
determine the stiffness of a conceptual femoral stem
prototype. The prosthesis with graded controlled
stiffness was obtained by varying the geometry of a
metal core with the thickness of a composite layer
structure. To determine the variability of the stiffness
(EI = Youngs modulus times second moment of area)
along the length of a manufactured prototype, the
displacement distributions were assessed and compared
by different methods. The experimental measurements
were obtained with an electronic speckle pattern
interferometry set-up (ESPI); the numerical
displacements were obtained using the finite element
method; the displacements were also analytically
calculated by integration of the differential equation of
the displacement function of a cantilever beam.
Overall, the prosthesis displacement distributions
obtained for all methods produced very similar results.
However, at the clamping region of the prosthesis,
significant differences were observed between the
experimental data and the results calculated using the
analytical expression. At the loading point a relative
displacement difference of the order of 5% was
obtained, comparing the experimental and the analytical-
numerical procedures.
1. INTRODUCTION
Composites, in the spectrum of available materials, are
the ones best suited for the design of graded modulus
components. In fact, they offer the potential to tailor the
component properties by selecting appropriate fibre and
matrix materials and spatially controlling the
composition and configuration [1]. It is therefore
possible to control the prosthesis stiffness to closely
approximate the properties of the femur and obtain high
stiffness where needed.
Even though composite materials offer design
flexibility, it can be extremely difficult to design and
I3A, Espaa, 2003
manufacture a very highly differentiated material
modulus structure. To overcome this design obstacle, the
present discussed design concept is based on a
combination of a metal core (to give high proximal
stiffness) bonded to a reinforced polymeric composite
layer (for low distal stiffness) [1]. The arrangement of
the geometry of the core with the composite material
modulus and thickness permitted a structure with
pseudo-optimised stiffness. An appropriate combination
of stiff and flexible materials can achieve the same effect
of a totally composite material that would virtually
contain the highly differentiated elastic modulus.
The proposed design is based on the concept
discussed by Kuiper [2,3], with the prosthesis having a
relatively high proximal-medial modulus and a receding
distal modulus matching the cortical bone modulus at
the prosthesis tip. This novel prosthesis consists of an
inner cobalt-chrome (E=200 GPa) core surrounded by a
flexible composite outer layer (E=10 GPa) [4,5]. The
composite layer elastic modului were obtained
experimentally testing tubular specimens of hybrid
glass-carbon fibre reinforced with epoxy resin. Details
of the mechanical characterisation of the composite
structure are given in Ref. [4].
Stiffness (EI) is the product of second moment of
area (I) and the elastic modulus (E) of the material, and
therefore two design variables exist: the modulus and the
geometry. For a non-cemented design, the geometry
cannot be significantly changed, and in this case the only
design variable is the elastic modulus of the material.
Simes et al [1] determined the front plane stiffness
(EIy) of a cemented (1.5 mm cement mantle thickness)
and non-cemented cobalt-chrome and titanium Freeman
hip prostheses [1].
The geometry is based on a modified version of the
Freeman hip prosthesis, comprising a straight-backed
cylindrical stem (16 mm diameter) with a flat wedge (10
mm thick) attached to the proximal medial third of the
prosthesis. The design also includes an increased
thickness composite layer on the proximal medial aspect
of the prosthesis for a distance of 5 mm below the neck The prototype was left post curing for 24h at 80 C.
resection level (figure 1). Figure 2 illustrates the manufactured prototype used to
In order to calculate the thickness of the outer validate the design concept.
composite layer, the required variation of stiffness along
the prosthesis needs to be known. For this purpose, a
numerically optimised prosthesis was used as a
reference, and data extracted from the work of Kuiper
[2], with Youngs modulus varying continuously over
the prosthesis length. The prosthesis was analytically
separated in two parts: a straight-backed cylindrical stem
and a proximal medial wedge (figure 1). For both
components, Youngs modulus was assumed to vary
along the component length. The modulus of the
straight-backed stem was varied from 80 GPa
proximally to 20 GPa distally. The modulus of the
proximal medial wedge was varied from 150 GPa
proximally to 100 GPa at the intersection with the
straight-backed stem. Contrarily to the 100 GPa
proximal Youngs modulus used in Kuipers work [2], a
modulus of 150 GPa at the proximal-medial side of the
prosthesis was considered.

Figure 2 Composite hip prosthesis [3-7].

2.1. Composite prosthesis stiffness distribution

To obtain the adequate thickness for the composite layer

was implemented a mathematical model based on the
hypothesis that the stiffness of the optimised prosthesis
is the same as the stiffness of the controlled stiffness
prosthesis [6]:

(EI y )opt = (EI y )mc + (EI y )cl (1)

where (EIyy)opt, (EIyy)mc and (EIyy)cl are the optimised,

metal core and composite layer bending stiffness
respectively. Considering that Youngs modulus of the
layer is constant throughout the stem, the second
Figure 1 Composite prosthesis geometry [6]. moment of area (Iyy)cl of the layer is

2. MATERIALS AND METHODS (EI y )opt + (EI y )mc

(I y )cl = E cl
(2)
The manufactured prototype used in this study
integrates a stiff metal core bonded to a composite
Developing equation (2) and considering the second
material made of an epoxy resin reinforced with carbon-
moment of area of a circular section (distal part of the
glass braided pre-forms and has been described in detail
prosthesis), the thickness t of the composite layer is:
elsewhere [1, 4-7]. A prototype of the novel design was
manufactured using compression moulding composite
E 0.25
technology. Carbon-glass braided pre-forms were d opt E cl
t = cl 1 (3)
located sequentially in layers around a metal core. A 2 E mc E cl



mean thickness of 0.35 mm was considered for each
layer and the total number of layers was calculated at
where dcl is the outside diameter of the circular cross-
different locations of the prosthesis. The core was
section of the layer (figure 1). The diameter of the
wrapped with impregnated pre-forms and placed inside a
circular section of the metal core (dmc) is obtained by
mould, which was clamped using a press stamp. The
dmc=dcl-2t.
laminate was left curing at room temperature for 24h.
 The same procedure was performed for the
rectangular section (proximal-medial side of the
prosthesis) of dimensions acl x bcl (figure 1). The
surrounding layer thickness is obtained by the following
equation:
E opt E cl
(a cl 2t )(b cl 2t )3 = a cl b 3cl (4)
E mc E cl
The rectangular metal core dimensions are obtained
using amc=acl-2t and bmc=bcl-2t. Thickness t is obtained
using the numerical bisection method to solve the above
equation. The thickness of the layer depends not only on
the optimum stiffness, but also on the elastic modulus of
the layer.
Although the modulus values have been determined
for the proximal-medial, proximal-lateral and distal
sections of the optimised prosthesis (150, 80 and 20 GPa
respectively), the distribution of the modulus can vary
along the length of the stem. Simes et al [1] studied
three variations of the optimized prosthesis, where the
modulus of the stem was assumed to vary as a linear,
square root and logarithmic function of the stem length.
The results obtained were not significantly different.
However, the linear controlled stiffness prosthesis
produced the best strain energy results; on the other
hand, the logarithmic controlled stiffness produced
slightly lower cancellous bone stresses [1,6]. A linear
variation of the Youngs modulus was assumed in the
study hereby described.
For the distal and proximal-lateral parts of the
prosthesis, the following relationship between the
optimal modulus and the axial prosthesis coordinate was
considered (z [0, 160]):
E(z )opt = 0.375z + 20 (5)
Recalling equation (3), the optimal thickness from the
distal to the proximal-lateral side of the prosthesis for
equation (5) is as follows:
0.375z + 20 E cl
0.25
t (z ) = 81
(6)
200 E cl
(centre of mass) and L(z) (variable length of the flat
For the proximal-medial region of the prosthesis,
the relationship between the optimized modulus and the
x coordinate (figure 1) was obtained assuming a starting
modulus of 100 GPa to a final modulus of 150 GPa. The
linear relationship between the optimal modulus and the
x coordinate for the proximal-medial side is as follows:
E(x )opt = 2x + 8 (7)
The dimension bcl (figure 1) is related with the
coordinate x as bcl=70-1.6x. Replacing this equation and
the above equation in equation (4), the variable t for the
proximal-medial side is:
[10 2t (x)][70 1.6x 2t (x)]3 = 10 2x + 80 E cl (70 1.6x )3 (8)
200 E cl
for x [10, 35]. Thickness t is obtained using the
numerical bisection method to solve the above equation.
A prototype was manufactured, where the thickness
of the composite structure, as well as the dimensions of
the inner core were determined using the above
equations. A detailed explanation on the design and
manufacturing of the novel composite hip stem can be
found in Refs. [1, 4-6].
2.2. Analytical displacement distribution
A mathematical model was developed to obtain the
analytical solution of the lateral displacements of the
prosthesis loaded as a cantilever beam. Assuming small
deformations the displacement distribution of a beam
can be obtained by integrating the equation:
d 2 y( z ) M( z)
= (9)
dz 2 E ( z ) I y (z )
where y(z) is the displacement function, E(z) the
Youngs modulus, M(z) the moment due to the loading,
and Iy(z) the second moment of area, all functions of the
z coordinate. The second moment of area function was
obtained considering the prosthesis geometry and
dimensions. The function characterizing the middle-
distal and proximal-lateral stiffness (Sdml) was obtained
using equation:
R (z )4
Sdml = E(z ) (10)
4
where R=60/17 + z/17 (0<x<96) is the radius of the
circular section as a function of the z coordinate.
For the proximal-medial part of the prosthesis, the
second moment of area function is a more complex one,
and the sum of four elementary geometries (figure 3)
was considered.
The second moment of area function for this region
of the prosthesis was obtained considering function G(z)
wedge part of the prosthesis).
Figure 3 Approximated proximal cross-section of the
flat wedge part of the prosthesis.
 Considering the geometry of figure 3, the following The analytical lateral displacements of the
relationships can be derived: prosthesis, loaded as a cantilever beam, were obtained
by integrating equation (9). For the controlled-stiffness
r prosthesis, the Youngs modulus function E(z) (in GPa)
= 180 arcsin (11)
R was replaced by the following one:

4 130
E(z) = 20 + z (22)
A x i i 162

G (z ) = i =1 (12)
4 for z [0, 160]. Substituting equation (22) into equation
Ai (9), it is possible to determine the displacement
i =1 distribution along the lateral side of the composite stem
and compare it with the ones obtained with the finite
L(z) = ztg30 + R cos r (13) element analysis and with the experimental study.
The numerical integration of equation (9) was
where Ai and xi are the correspondent area and performed with Mathematica software.
coordinate x for each of the geometric figures of the
whole cross section (figure 3). For L(z), 96<z<162. The 2.3. Numerical (FEA) displacement distribution
G(z) function can be obtained replacing the following
equations: A finite element model was used to test if the second
moment of area function, equation (16), would provide
4
r 2
identical results. Hence, the analytical displacement
A = Ri
2
rR cos + 2rB(z) +
2
(14) distribution was compared with the same resulting from
i =1 the finite element analysis (FEA), where constant
4 material modulus prosthesis was considered. For the
A x i i =
2 3
3
2
R sin + rR 2 cos 2 + rB2 (z) 2rB(z )R cos
3 finite element analysis, the prosthesis was modelled with
i =1 SolidWorks computer aided design software and

r 2 2
R cos + B(z) r 2 + r 3 (15) simulated with Hypermesh finite element analysis
2 2 3 software. The finite element model was composed of
21765 tetrahedral four-node elements and 5340 nodes.
The final function for the second moment of area Figure 4 shows the finite element mesh of the prosthesis.
was obtained considering the sum of the second moment The same was loaded laterally-medially by a single load
of area of each of the elementary geometries: of 700 N.
The displacement data in the prosthesis front plane
4 were very identical (maximum difference of 32 m).
I y (z ) = I
i =1
y i (z) = I y1 (z) + I y 2 (z) + I y 3 (z) + I y 4 (z) (16) This fact gave us the necessary confidence to use the
Iy(z) equation to derive the lateral side displacements
and compare them with the same obtained
where experimentally.
sin 2 4 sin 2
I y1 = R 4 + + R 2 2R sin + G (z ) (17)
4 8 9 3 2.4. Experimental displacement distribution

2 To experimentally obtain the variation of the

rR 3 cos 3 2R cos
Iy2 = rR cos + G (z ) (18) prototype prosthesis stiffness, the method implemented
18 3
consisted on the comparison of the prosthesis lateral
displacement field, measured using non-contact
2
rL3 (z) L( z) technique, namely ESPI (Electronic Speckle Pattern
Iy3 = + 2rL(z) R cos G (z) (19)
6 2 Interferometry), with the one obtained with the
analytical model [7]. The determination of the
8 r 2 4r
2 displacement field for a variable modulus stem using the
Iy4 = r4 + L(z) R cos + G (z ) (20) finite element method would be time consuming since a
8 9 2 3
high-density mesh would be necessary. In this
calculation it would also be necessary to assign for each
Finally, the prosthesis proximal stiffness was
row of elements along the stems axis a different
obtained using:
Youngs modulus. Having said so, the finite element
model was only used to validate the analytical model, by
Spm = I y (z )E(z ) (21)
simulating a constant material stem.
 The displacement field obtained resulted from the
phase map calculation by using an image-processing
algorithm based on phase stepping techniques. The 2
phase difference corresponds to a /2 displacement;
therefore, the displacement point on the prosthesis
surface was obtained by:

y( z) = fringe _ order (23)
2
Figure 4 Finite element mesh of the prosthesis.
For the laser used, =632 nm, and replacing this
In both, the numerical and experimental models, the
value in equation (23), the displacements were obtained
prosthesis was loaded as a cantilever beam. No torsional
along the lateral side of the prosthesis.
force due to the anterior loading component of the hip
joint force was taken into account within the
3. RESULTS AND DISCUSSION
experimental setup. The objective within this part of the
study was to validate the controlled stiffness concept, by
The applicability of the analytical second moment of
determining an optimal variation composite thickness,
area function of the prosthesis model was verified by
assuming that the bending stiffness of the optimised
comparison of the displacements calculated with the
prosthesis is the same as the bending stiffness of a
finite element method and the numerical integration of
prosthesis composed of a metal core and a composite
equation (9). The results obtained for both methods were
layer. For an equivalent torsional stiffness, the variation
similar along the prosthesis length. The maximum
of the optimal composite layer thickness was inferior to
displacement observed was 1.704 mm for the numerical
the one obtained for the equivalent bending stiffness,
integration of the analytical model and 1.720 mm for the
therefore torsion played a second-order effect
finite element method. This fact gave us the necessary
concerning the objectives of the study hereby presented.
confidence to use the analytical second moment of area
With this technique (ESPI), the assessment of the
function to obtain the displacements of the controlled
displacement field of the prototype was possible with no
stiffness prototype analytically [7].
need of contact or surface preparation and with very
Table 1 shows the displacement values measured
high resolution, on the order of magnitude of the laser
experimentally and those obtained analytically. Figure 6
wavelength. The experimental displacements were
shows a graphical comparison of the ESPI and
obtained with a manufactured prototype.
numerical integration displacement fields. A relatively
A stiff support was used to hold the prosthesis 30
good correlation between these was obtained using the
mm from its distal end. The magnitude of the
method described, and so we can state with some
displacement field measured was of the order of a
certainty that the manufactured prosthesis prototype
micron. A very low load of P = 0.2 N was used, which
possesses equivalent optimised stiffness. This means that
allowed us to obtain a reasonable number of fringes to
the prosthesis was manufactured with an equivalent
calculate the displacement values. The experimental
Youngs modulus as stated in the Materials and Methods
setup used is shown in figure 5. The interferometer arms
section. However, at the distal part of the prosthesis
are oriented in such a way that the sensitivity vector was
where it was rigidly fixed, the highest displacement
coincident with the direction of the displacements
difference was observed, which was due to the nature of
measured, that is, perpendicular to the lateral surface of
the experimental set-up.
the prosthesis.
The displacement difference near the prosthesis
fixation device was 400% and gradually diminished up
to a difference of 2.5% at the last observed fringe, which
was localised at a distance of 15 mm from the applied
load.
The higher differences observed at the fixation
region of the prosthesis may have resulted from a less
efficient fixation of the prosthesis. In the analytical-
numerical model, the fixation of the prosthesis was
considered to be ideal. We must say that the measured
displacements are of the order of a micron and can
easily be influenced by the experimental setup. The
maximum displacement obtained with the ESPI
technique was 4.3 m; for the analytical model, the
Figure 5 ESPI set-up.
maximum displacement was 4.1 m, a relative
difference of 5%.
 analytical model. Relative to the prosthesis concept, it is
possible to generate optimised Youngs modulus data by
overcoming possible composite manufacturing
difficulties.

REFERENCES

[1] Simes, J. A., Taylor, M., Marques, A. T. e Jeronimidis,

G., 1998, Preliminary investigation of a novel controlled
stiffness proximal femoral prosthesis, Proc Inst Mech Eng
Part H J Eng Med, 212, pp. 165-175.

[2] Kuiper, J. H., 1993, 1993, Numerical optimisation of

artificial hip joint designs, PhD Thesis, Katholieke
Universiteit Nijmegen, The Netherlands.

[3] Kuiper, J. H. And Huiskes, R., 1993, Numerical

Figure 6 Analytical and experimental displacement optimization of hip-prosthetic stem material, In Computer
distributions [7]. Methods in Biomechanics and Biomedicine, Middleton et al.,
(Eds.), Gordon and Breach, New York, pp. 78-84.
Fringe Position on Experimental Analytical
[4] Simes, J. A. e Marques, A. T., 2001, Determination of
Number prosthesis
stiffness properties of braided reinforced composites for the
(mm) (m) (m)
design of a hip prosthesis, Compos Part A Appl S, Vol. 32,
N 5, pp. 655-662.
1 33 0.316 0.102
2 46 0.632 0.252 [5] Simes, J. A., Marques, A. T. e Jeronimidis, G., 2000,
3 57 0.948 0.601 The design of a controlled-stiffness composite proximal
4 68 1.264 0.922 femoral prosthesis, Compos Sci Technol, 60, pp. 559-567.
5 78 1.580 1.258
6 87 1.896 1.581 [6] Simes, J. A., Marques, A. T. e Jeronimidis, G., 2003, A
7 97 2.212 1.916 composite hip femoral prosthesis, J Appl Biomat & Biomech
8 106 2.528 2.265
(submitted).
9 116 2.844 2.653
10 126 3.160 3.028
[7] Simes, J. A., Monteiro, J. e Vaz, M. A., 2001,
11 137 3.476 3.484
12 145 3.792 3.852
Numerical-experimental method for the validation of a
13 156 4.108 4.338 controlled stiffness femoral prosthesis, J Biomech Eng Trans
ASME, Vol. 123, pp. 234-238.

Table 1 - Displacement field determined analytical and

measured experimental on the composite prosthesis
prototype [7].

4. CONCLUDING REMARKS

The methodology described within this paper proved to

be suitable to validate the study. Having developed a
conceptual novel prosthesis with an objective to produce
numerical optimisation modulus data, it was necessary
to validate experimentally the variability of the
prototypes stiffness and therefore the concept.
However, the procedure only took into account the
stiffness of the prosthesis in the front plane and only
bending was considered, which can be a weak point of
the study. However, considering torsional stiffness and
other plane bending stiffness, as well as out-of-plane
bending would probably generate a very complex
analytical equation. The ESPI set-up would be much
more complex and difficult to control the loading. For
the purpose of the study, the experimental method based
on ESPI proved to be adequate to determine the
prosthesis displacements and upon comparison with the