Gap between the fragment and the tibia affects the stability of tibial tubercle osteotomy: A finite element study
| Autor: | Chih Wei Chang, Yen Nien Chen, Yao Te Peng, Chun Ting Li, Chih Han Chang, Chi Rung Chung |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Materials science medicine.medical_treatment Bone Screws Finite Element Analysis 0206 medical engineering Biomedical Engineering Biophysics 02 engineering and technology Osteotomy Contact force Stress (mechanics) 03 medical and health sciences 0302 clinical medicine medicine Tibia Mechanical Phenomena Orthodontics Plane (geometry) Fragment (computer graphics) musculoskeletal system 020601 biomedical engineering Finite element method medicine.anatomical_structure Cortical bone 030217 neurology & neurosurgery |
| Zdroj: | Medical Engineering & Physics. 68:57-64 |
| ISSN: | 1350-4533 |
| DOI: | 10.1016/j.medengphy.2019.03.012 |
| Popis: | Tibial tubercle osteotomy (TTO) is commonly performed in cases of complicated juxta-articular trauma or revision total knee arthroplasty. However, strategies for firmly fixing the resulting osteotomy bone fragment are not sufficiently understood. This study aims to investigate the effect of the location of the gap between the fragment and the tibia and with various fixed screw configurations on TTO stability, contact force on the fragment, and bone stress by using the finite element method. A TTO model with a 1-mm gap, either above or below the fragment, was developed. Furthermore, five screw configurations, including two parallel horizontal screws placed at 20- and 30-mm intervals, two parallel downward screws, two trapezoid screws, and two divergent screws, were used. A vertically upward 1600-N force was applied on the tibial tubercle to mimic a worst-case condition. Placing the fragment close to the superior cutting plane (above the gap) yielded greater stability and less stress on the bone than did placing it close to the inferior cutting plane. The superior cutting plane of the tibia generated the largest contact force on the superior plane of the fragment for static balance under loading. Additionally, among all screw configurations, the configuration involving two parallel downward screws resulted in the highest stability but also the greatest stress on the cortical bone. The fragment obtains a solid barrier and support from the tibia immediately after surgery to against the patellar tension force when the fragment is close to the superior cutting plane of the tibia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect