{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:00:56Z","timestamp":1774368056900,"version":"3.50.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016156","name":"U.S. Army Medical Research and Development Command","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabilit. Sci."],"abstract":"<jats:p>Cadaveric mechanical testing of a percutaneous osseointegration docking system (PODS) for osseointegration (OI) prosthetic limb attachment revealed that translation of the exact system from the humerus to the tibia may not be suitable. The PODS, designed specifically for the humerus achieved 1.4\u20134.8 times greater mechanical stability in the humerus than in the tibia despite morphology that indicated translational feasibility. To better understand this discrepancy, finite element analyses (FEAs) modeled the implantation of the PODS into the bones. Models from cadaveric humeri (<jats:italic>n<\/jats:italic> = 3) and tibia (<jats:italic>n<\/jats:italic> = 3) were constructed from CT scans, and virtual implantation preparation of an array of endoprosthesis sizes that made contact with the endosteal surface but did not penetrate the outer cortex was performed. Final impaction of the endoprosthesis was simulated using a displacement ramp function to press the endoprosthesis model into the bone. Impaction force and maximum first principal (circumferential) stress were recorded to estimate stability and assess fracture risk of the system. We hypothesized that the humerus and tibia would have different optimal PODS sizing criteria that maximized impaction force and minimized first principal stress. The optimal sizing for the humerus corresponded to implantation instructions, whereas for the tibia optimal sizing was three times larger than the guidelines indicated. This FEA examination of impaction force and stress distribution lead us to believe that the same endoprosthesis strategy for the humerus is not suitable for the tibia because of thin medial and lateral cortices that compromise implantation.<\/jats:p>","DOI":"10.3389\/fresc.2021.744674","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T11:48:20Z","timestamp":1638272900000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Finite Element Analysis of Transhumeral and Transtibial Percutaneous Osseointegrated Endoprosthesis Implantation"],"prefix":"10.3389","volume":"2","author":[{"given":"Carolyn E.","family":"Taylor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heath B.","family":"Henninger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent N.","family":"Bachus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S142","DOI":"10.1016\/j.jcot.2019.05.025","article-title":"The future of the amputees with osseointegration: a systematic review of literature","volume":"11","author":"Gerzina","year":"2020","journal-title":"J Clin Orthop Trauma."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2966","DOI":"10.1007\/s11999-014-3523-z","article-title":"Radiographic evaluation of bone adaptation adjacent to percutaneous osseointegrated prostheses in a sheep model","volume":"472","author":"Jeyapalina","year":"2014","journal-title":"Clin Orthop Relat Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2957","DOI":"10.1007\/s11999-013-3381-0","article-title":"Progression of bone ingrowth and attachment strength for stability of percutaneous osseointegrated prostheses","volume":"472","author":"Jeyapalina","year":"2014","journal-title":"Clin Orthop Relat Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s10856-017-5980-x","article-title":"A 24-month evaluation of a percutaneous osseointegrated limb-skin interface in an ovine amputation model","volume":"28","author":"Jeyapalina","year":"2017","journal-title":"J Mater Sci: Mater Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0221850","DOI":"10.1371\/journal.pone.0221850","article-title":"Variation in bone response to the placement of percutaneous osseointegrated endoprostheses: A 24-month follow-up in sheep","volume":"14","author":"Jeyapalina","year":"2019","journal-title":"PLoS ONE."},{"key":"B6","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/01.GOX.0000546947.26338.0d","article-title":"Development of a percutaneous prosthesis for transfemoral amputees, the Utah experience","volume":"6","author":"Agarwal","year":"2018","journal-title":"Plastic Reconstructiv Surg Glob Open."},{"key":"B7","article-title":"\u201cUse of CT imaging for analyzing bone remodelling around an osseointegrated implant,\u201d","volume-title":"International Society for Technology in Arthroplasty","author":"Wankier","year":"2019"},{"key":"B8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.clinbiomech.2019.12.005","article-title":"Initial stability of a percutaneous osseointegrated endoprosthesis with proximal interlocking screws for transhumeral amputees","volume":"72","author":"Drew","year":"2020","journal-title":"Clinic Biomech."},{"key":"B9","article-title":"Cortical and medullary morphology of the tibia","volume-title":"Anat Rec.","author":"Taylor","year":"2020"},{"key":"B10","doi-asserted-by":"publisher","first-page":"S270","DOI":"10.1016\/j.arth.2018.01.020","article-title":"Impaction force influences taper-trunnion stability in total hip arthroplasty","volume":"33","author":"Danoff","year":"2018","journal-title":"J Arthroplasty."},{"key":"B11","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/00003086-198810000-00007","article-title":"The uncemented total hip arthroplasty. 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