An Original Computational Framework for Patient-Specific Simulation of Orthopaedic Implant Failure Risk in Nigerian Patients with Bone Mineral Deficiency

Orthopaedic implant failure rates in Nigerian patients are elevated relative to published data from high-income countries, and differences in bone mineral density, cortical thickness, and bone geometry in Nigerian patients with prevalent vitamin D and calcium deficiency are likely contributors to this excess failure risk, yet computational tools for patient-specific implant failure prediction that incorporate these population-specific bone quality characteristics do not exist. This dissertation develops an original computational framework for patient-specific simulation of orthopaedic implant failure risk in Nigerian patients with bone mineral deficiency, making contributions to computational orthopaedic biomechanics and to the clinical management of bone-implant systems in nutritional deficiency contexts. The framework development comprises five methodological phases. The first phase establishes a normative bone geometry and mineral density database from quantitative CT imaging of two hundred Nigerian adults spanning age groups and including patients with confirmed vitamin D deficiency, collected at the National Orthopaedic Hospital Enugu. The second phase develops patient-specific finite element model generation pipelines mapping CT density values to orthotropic material properties using validated density-elasticity relationships recalibrated for Nigerian bone composition data. The third phase constructs fatigue failure models incorporating bone quality-dependent crack initiation and propagation parameters identified from micro-CT analysis of resected bone specimens. The fourth phase integrates periprosthetic bone remodelling algorithms driven by Wolff's law, parameterized with Nigerian patient-specific loading histories from instrumented implant telemetry. The fifth phase validates framework predictions against implant failure outcomes from a longitudinal cohort of three hundred orthopaedic implant recipients at three Nigerian centres. Keywords: orthopaedic implant failure, finite element modelling, bone mineral deficiency, patient-specific simulation, Nigeria.