D Belaid1, T Vendeuvre2, A Bouchoucha3, F Brémand4, C Brèque5, P Rigoard6, A Germaneau7. 1. Department of Mechanical Engineering, Faculty of Technology Sciences, University of Mentouri Brothers - Constantine, P.O. Box 325, Ain-El-Bey Way, Constantine 25017, Algeria; Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France. 2. Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France; Department of Orthopaedic Surgery and Traumatology, CHU Poitiers, Poitiers, France; Spine & neuromodulation functional unit, Department of neurosurgery, CHU Poitiers, PRISMATICS Lab, Poitiers, France. 3. Department of Mechanical Engineering, Faculty of Technology Sciences, University of Mentouri Brothers - Constantine, P.O. Box 325, Ain-El-Bey Way, Constantine 25017, Algeria. 4. Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France. 5. Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France; ABS Lab, Université de Poitiers, France. 6. Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France; Spine & neuromodulation functional unit, Department of neurosurgery, CHU Poitiers, PRISMATICS Lab, Poitiers, France. 7. Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France. Electronic address: arnaud.germaneau@univ-poitiers.fr.
Abstract
BACKGROUND: Treatment for fractures of the tibial plateau is in most cases carried out by stable fixation in order to allow early mobilization. Minimally invasive technologies such as tibioplasty or stabilization by locking plate, bone augmentation and cement filling (CF) have recently been used to treat this type of fracture. The aim of this paper was to determine the mechanical behavior of the tibial plateau by numerically modeling and by quantifying the mechanical effects on the tibia mechanical properties from injury healing. METHODS: A personalized Finite Element (FE) model of the tibial plateau from a clinical case has been developed to analyze stress distribution in the tibial plateau stabilized by balloon osteoplasty and to determine the influence of the cement injected. Stress analysis was performed for different stages after surgery. FINDINGS: Just after surgery, the maximum von Mises stresses obtained for the fractured tibia treated with and without CF were 134.9 MPa and 289.9 MPa respectively on the plate. Stress distribution showed an increase of values in the trabecular bone in the treated model with locking plate and CF and stress reduction in the cortical bone in the model treated with locking plate only. INTERPRETATION: The computed results of stresses or displacements of the fractured models show that the cement filling of the tibial depression fracture may increase implant stability, and decrease the loss of depression reduction, while the presence of the cement in the healed model renders the load distribution uniform.
BACKGROUND: Treatment for fractures of the tibial plateau is in most cases carried out by stable fixation in order to allow early mobilization. Minimally invasive technologies such as tibioplasty or stabilization by locking plate, bone augmentation and cement filling (CF) have recently been used to treat this type of fracture. The aim of this paper was to determine the mechanical behavior of the tibial plateau by numerically modeling and by quantifying the mechanical effects on the tibia mechanical properties from injury healing. METHODS: A personalized Finite Element (FE) model of the tibial plateau from a clinical case has been developed to analyze stress distribution in the tibial plateau stabilized by balloon osteoplasty and to determine the influence of the cement injected. Stress analysis was performed for different stages after surgery. FINDINGS: Just after surgery, the maximum von Mises stresses obtained for the fractured tibia treated with and without CF were 134.9 MPa and 289.9 MPa respectively on the plate. Stress distribution showed an increase of values in the trabecular bone in the treated model with locking plate and CF and stress reduction in the cortical bone in the model treated with locking plate only. INTERPRETATION: The computed results of stresses or displacements of the fractured models show that the cement filling of the tibial depression fracture may increase implant stability, and decrease the loss of depression reduction, while the presence of the cement in the healed model renders the load distribution uniform.
Authors: A Moufid; P Bokam; G Harika-Germaneau; M Severyns; L Caillé; V Valle; T Vendeuvre; A Germaneau Journal: Front Bioeng Biotechnol Date: 2022-07-04