Effects of plate contouring quality on the biomechanical performance of high tibial osteotomy fixation: A parametric finite element study

2022 ◽  
pp. 095441192110692
Author(s):  
Zahra Hayatbakhsh ◽  
Farzam Farahmand
Keyword(s):  
Finite Element ◽  
High Tibial Osteotomy ◽  
Plate Fixation ◽  
Element Model ◽  
Von Mises Stress ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Intimate Contact ◽  
Initial Shape ◽  
Pull Out

Locking plates have threaded holes, in which threaded-head screws are affixed. Hence, they do not need to be in intimate contact with underlying bone to provide fixation. There are, however, reports that a large distance between the plate and the bone might cause clinical complications such as delayed union or nonunion, screw pull out, and screw and plate breakage. Considering the diversity in the capabilities and costs of different plate customization techniques, the purpose of this study was to investigate the effect of the plate contouring quality on the biomechanical performance of high tibial osteotomy (HTO) fixation. A finite element model of proximal tibia was developed in Abaqus, using the QCT data of a cadaver. The model was then subjected to open-wedge HTO (correction angle 12°) with TomoFix plate fixation. The sagittal curvature of the plate was changed parametrically to provide certain levels of geometrical fit, and the biomechanical performance parameters of fixation were assessed. Results indicated 5%, 9% and 38% increase in the stiffness of the construct, and the von Mises stress in the plate and locking screw just above the osteotomy site, respectively, when the level of fit of plate changed from 0% (initial non-contoured initial shape) to 100% (fully adapted shape). The same change decreased the pressure at the lateral hinge of the osteotomy by 61%, and the mean of the tensile stress on the screw shaft by 12%. It was concluded that the level of fit has conflicting effects on the biomechanical parameters of the HTO fixation system, that is, the structural stiffness, the pressure at the lateral hinge, the stresses in the plate and screws, and the pull out resistance of the screws. In particular, for HTO patients with high quality bone, the optimal level of fit should provide a tradeoff between these parameters.

scholarly journals Biomechanical evaluation of high tibial osteotomy plate with internal support block using finite element analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247412
Author(s):  
Jesse Chieh-Szu Yang ◽  
Kuan-Yu Lin ◽  
Hsi-Hsien Lin ◽  
Oscar K. Lee
Keyword(s):  
Finite Element ◽  
High Tibial Osteotomy ◽  
Tibial Plateau ◽  
Bone Plate ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Sit To Stand ◽  
Internal Support ◽  
Locking Screw ◽  
Tomofix Plate

Background/Objective High tibial osteotomy (HTO) is a common treatment for medial knee arthrosis. However, a high rate of complications associated with a plate and a significant loss of correction have been reported. Therefore, an internal support block (ISB) is designed to enhance the initial stability of the fixation device that is important for successful bone healing and maintenance of the correction angle of the osteotomy site. The purpose of this study was performed to examine if an internal support block combined with a plate reduces the stress on the plate and screw area. Methods Finite element models were reconstructed following three different implant combinations. Two loading conditions were applied to simulate standing and initial sit-to-stand postures. Data analysis was conducted to evaluate the axial displacement of the posteromedial tibial plateau, which represents the loss of the posteromedial tibial plateau in clinical observation. Moreover, the stresses on the bone plate and locking screws were evaluated. Results Compared to the TomoFix plate, the ISB reduced the axial displacement by 73% and 76% in standing and initial sit-to-stand loading conditions, respectively. The plate with an ISB reduced stress by 90% on the bone plate and by 73% on the locking screw during standing compared to the standalone TomoFix plate. During the initial sit-to-stand loading condition, the ISB reduced the stress by 93% and 77% on the bone plate and the locking screw, respectively. Conclusion The addition of the PEEK block showed a benefit for structural stability in the osteotomy site. However, further clinical trials are necessary to evaluate the clinical benefit of reduced implant stress and the internal support block on the healing of the medial bone tissue.

scholarly journals The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates

2018 ◽  
Vol 7 (12) ◽  
pp. 639-649 ◽  
Author(s):  
A. R. MacLeod ◽  
G. Serrancoli ◽  
B. J. Fregly ◽  
A. D. Toms ◽  
H. S. Gill
Keyword(s):  
Finite Element ◽  
Fracture Healing ◽  
High Tibial Osteotomy ◽  
Early Stage ◽  
Osteotomy Site ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Industry Standard ◽  
Plate Design ◽  
Standard Plate

Objectives Opening wedge high tibial osteotomy (HTO) is an established surgical procedure for the treatment of early-stage knee arthritis. Other than infection, the majority of complications are related to mechanical factors – in particular, stimulation of healing at the osteotomy site. This study used finite element (FE) analysis to investigate the effect of plate design and bridging span on interfragmentary movement (IFM) and the influence of fracture healing on plate stress and potential failure. Materials and Methods A 10° opening wedge HTO was created in a composite tibia. Imaging and strain gauge data were used to create and validate FE models. Models of an intact tibia and a tibia implanted with a custom HTO plate using two different bridging spans were validated against experimental data. Physiological muscle forces and different stages of osteotomy gap healing simulating up to six weeks postoperatively were then incorporated. Predictions of plate stress and IFM for the custom plate were compared against predictions for an industry standard plate (TomoFix). Results For both plate types, long spans increased IFM but did not substantially alter peak plate stress. The custom plate increased axial and shear IFM values by up to 24% and 47%, respectively, compared with the TomoFix. In all cases, a callus stiffness of 528 MPa was required to reduce plate stress below the fatigue strength of titanium alloy. Conclusion We demonstrate that larger bridging spans in opening wedge HTO increase IFM without substantially increasing plate stress. The results indicate, however, that callus healing is required to prevent fatigue failure. Cite this article: A. R. MacLeod, G. Serrancoli, B. J. Fregly, A. D. Toms, H. S. Gill. The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates: An experimental and finite element study. Bone Joint Res 2018;7:639–649. DOI: 10.1302/2046-3758.712.BJR-2018-0035.R1.

scholarly journals Investigation of a Modified Novel Technique in Bilateral Sagittal Splitting Osteotomy Fixation: Finite Element Analysis and In Vitro Biomechanical Test

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Li-Ren Chang ◽  
Chien-Chung Chen ◽  
Seng Feng Jeng ◽  
Yu-Ray Chen ◽  
Lain-Chyr Hwang ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Plate Fixation ◽  
Von Mises Stress ◽  
Fixation Method ◽  
Osteotomy Site ◽  
Biomechanical Test ◽  
Fixation Failure ◽  
Element Analysis

Purpose. To evaluate the biomechanical properties of the modified novel 2-hole monocortical plate fixation (2HMCPf) and traditional 4-hole monocortical plate fixation (4HMCPf) techniques in bilateral sagittal splitting osteotomy (BSSO) synthesis using a finite element analysis (FEA) and an in vitro biomechanical test with the application of a shearing loading force on a sawbone mandible model. Materials and Methods. A three-dimensional mandible models were generated using the geometry obtained from the computerized tomography image of a sawbone mandible. Plates and screws were generated and combined with the mandible in a CAD environment. The 2HMCPf and traditional 4HMCPf techniques for BSSO osteosynthesis were then analyzed under the occlusal load using the FEA. An in vitro biomechanical test was executed to verify the result of FEA. The force on fixation failure and pattern of failure were recorded. Results. The results revealed that the von Mises Stress on the mandible cortical bone (75.98 MPa) and the screw/plate (457.19 MPa) of the 2HMCPf group was lower than that of the 4HMCPf group (987.68 MPa, 1781.59 MPa). The stress concentrated on the central region of the 4HMCPf group and the distal set of the 2HMCPf group. In vitro study using the sawbone mandible model showed mechanical failure at the region of the proximal segment near the osteotomy site with the 4HMCPf group (average 32.198 N) but no failure on the fixation sites with the 2HMCPf group. Instead, the mandible sawbone fractured on the condyle neck region (average 44.953 N). Conclusion. From the biomechanical perspective, we proved that the 2HMCPf method was able to withstand a higher shearing loading force than the 4HMCPf fixation method in BSSO osteosynthesis.

Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy

Injury ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 898-902 ◽  
Author(s):  
Raja Mohd Aizat Raja Izaham ◽  
Mohammed Rafiq Abdul Kadir ◽  
Abdul Halim Abdul Rashid ◽  
Md. Golam Hossain ◽  
T. Kamarul
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
High Tibial Osteotomy ◽  
Plate Fixation ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Element Analysis ◽  
Wedge High Tibial Osteotomy ◽  
Tomofix Plate

Assessing the Local Mechanical Environment in Medial Opening Wedge High Tibial Osteotomy Using Finite Element Analysis

2015 ◽  
Vol 137 (3) ◽  
Author(s):  
Yves Pauchard ◽  
Todor G. Ivanov ◽  
David D. McErlain ◽  
Jaques S. Milner ◽  
J. Robert Giffin ◽  
...  
Keyword(s):  
Finite Element ◽  
High Tibial Osteotomy ◽  
Volume Fraction ◽  
Compressive Strain ◽  
Tibial Osteotomy ◽  
Fe Modeling ◽  
Knee Alignment ◽  
Mechanical Environment ◽  
Significant Difference ◽  
Subject Specific

High-tibial osteotomy (HTO) is a surgical technique aimed at shifting load away from one tibiofemoral compartment, in order the reduce pain and progression of osteoarthritis (OA). Various implants have been designed to stabilize the osteotomy and previous studies have been focused on determining primary stability (a global measure) that these designs provide. It has been shown that the local mechanical environment, characterized by bone strains and segment micromotion, is important in understanding healing and these data are not currently available. Finite element (FE) modeling was utilized to assess the local mechanical environment provided by three different fixation plate designs: short plate with spacer, long plate with spacer and long plate without spacer. Image-based FE models of the knee were constructed from healthy individuals (N = 5) with normal knee alignment. An HTO gap was virtually added without changing the knee alignment and HTO implants were inserted. Subsequently, the local mechanical environment, defined by bone compressive strain and wedge micromotion, was assessed. Furthermore, implant stresses were calculated. Values were computed under vertical compression in zero-degree knee extension with loads set at 1 and 2 times the subject-specific body weight (1 BW, 2 BW). All studied HTO implant designs provide an environment for successful healing at 1 BW and 2 BW loading. Implant von Mises stresses (99th percentile) were below 60 MPa in all experiments, below the material yield strength and significantly lower in long spacer plates. Volume fraction of high compressive strain ( > 3000 microstrain) was below 5% in all experiments and no significant difference between implants was detected. Maximum vertical micromotion between bone segments was below 200 μm in all experiments and significantly larger in the implant without a tooth. Differences between plate designs generally became apparent only at 2 BW loading. Results suggest that with compressive loading of 2 BW, long spacer plates experience the lowest implant stresses, and spacer plates (long or short) result in smaller wedge micromotion, potentially beneficial for healing. Values are sensitive to subject bone geometry, highlighting the need for subject-specific modeling. This study demonstrates the benefits of using image-based FE modeling and bone theory to fine-tune HTO implant design.

scholarly journals Is Perpendicular Double Two-Hole Plates Fixation Superior to Single Four-Hole Plate Fixation to Treat Mandibular Symphysis Fracture?—A Finite Element Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8629
Author(s):  
Li-Ren Chang ◽  
Ya-Pei Hou ◽  
Ting-Sheng Lin
Keyword(s):  
Finite Element ◽  
Plate Fixation ◽  
Mandibular Condyle ◽  
Fracture Site ◽  
Von Mises Stress ◽  
Stress Concentrations ◽  
Element Analysis ◽  
Mandibular Symphysis ◽  
Lower Border ◽  
Von Mises

The effectiveness of a single four-hole plate (S4HP), perpendicularly oriented four-hole and two-hole plate (Per4H2HP), and perpendicularly oriented double two-hole plate (PerD2HP) for the fixation of a mandibular fracture was studied. A finite element analysis of the mandibular symphysis fractures treated with S4HP, Per4H2HP, and PerD2HP was performed. All surface nodes were fixed in the mandibular condyle region and occlusal muscle forces were applied. The maximal von Mises stress (MaxVMS) values of the plates, screws and screw holes were investigated. The displacement of the fracture site on the lower border of the mandibular symphysis was recorded. The displacement on the lower border of the fracture sites in the S4HP group was greater than that in the Per4H2HP group and the PerD2HP group. There was no eversion at the fracture site among all groups. Both the S4HP and Per4H2HP groups showed stress concentrations on the screws close to the fracture site. The MaxVMS increased when the number of screw holes on the mandibular anterior lower border decreased. The displacement of the fracture site and eversion with Per4H2HP and PerD2HP were far lower than those with S4HP. PerD2HP is a stable and green fixation technique for mandibular symphysis fractures.

An Improved Control Arm Design for a Commercial Vehicle

2021 ◽  
Author(s):  
Sinan Yıldırım ◽  
Ufuk Çoban ◽  
Mehmet Çevik
Keyword(s):  
Finite Element ◽  
Cost Effective ◽  
Element Model ◽  
Tensile Tests ◽  
The Body ◽  
Von Mises Stress ◽  
Driving Safety ◽  
Design Development ◽  
Element Analysis ◽  
Von Mises

Suspension linkages are one of the fundamental structural elements in each vehicle since they connect the wheel carriers i.e. axles to the body of the vehicle. Moreover, the characteristics of suspension linkages within a suspension system can directly affect driving safety, comfort and economics. Beyond these, all these design criteria are bounded to the package space of the vehicle. In last decades, suspension linkages have been focused on in terms of design development and cost reduction. In this study, a control arm of a diesel public bus was taken into account in order to get the most cost-effective design while improving the strength within specified boundary conditions. Due to the change of the supplier, the control arm of a rigid axle was redesigned to find an economical and more durable solution. The new design was analyzed first by the finite element analysis software Ansys and the finite element model of the control arm was validated by physical tensile tests. The outputs of the study demonstrate that the new design geometry reduces the maximum Von Mises stress 15% while being within the elastic region of the material in use and having found an economical solution in terms of supplier’s criteria.

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