The short- and long-term success of tibial cementless implants depends on the initial fixation stability provided primarily by posts and screws. Excessive relative motions at the bone-implant interface are known to inhibit bone ingrowth and, hence, biologic fixation. In this work, the performance of a number of fixation configurations under static and fatigue combined loads (i.e., compression plus shear) is investigated both experimentally and numerically. These results will permit both to compare different fixation types and to serve to validate a 3D finite element model that incorporates the measured nonlinear bone-implant friction and posts/screws pull-out tests. Once validated, the finite element model is also used to study the effect of different bone-implant friction models for porous coated posts and plate and of loading order of application on predictions.

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