Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy
Purpose: Tibial tubercle osteotomy (TTO) is a surgical technique used in the management of severe fractures of the knee joint and revision total knee arthroplasty. Limited research discusses the performance of the osteotomy and fixation of the TTO with screws. Therefore, this study investigated the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-07-01
|
| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/2309499019861145 |
| _version_ | 1818516475222163456 |
|---|---|
| author | Chih-Wei Chang Yen-Nien Chen Chun-Ting Li Chi-Rung Chung Chih-Han Chang Yao-Te Peng |
| author_facet | Chih-Wei Chang Yen-Nien Chen Chun-Ting Li Chi-Rung Chung Chih-Han Chang Yao-Te Peng |
| author_sort | Chih-Wei Chang |
| collection | DOAJ |
| description | Purpose: Tibial tubercle osteotomy (TTO) is a surgical technique used in the management of severe fractures of the knee joint and revision total knee arthroplasty. Limited research discusses the performance of the osteotomy and fixation of the TTO with screws. Therefore, this study investigated the effects of fragment shape and screw configuration on the mechanical behavior in the fixation of the TTO using the finite element (FE) method. Methods: FE TTO models with three fragment shapes and three screw configurations were developed. The three fragment shapes were a step cut, bevel cut, and straight cut. The screw configurations were two parallel horizontal and downward screws and two trapezoidal screws. A 1654-N upward tension force was applied on the tibia tubercle, and the distal end of the tibia was completely fixed. Results: The results indicated that the step cut resulted in higher stability than the bevel and straight cut, but the stress was higher as well. Among the screw configurations, two parallel downward screws resulted in the highest stability, given the same fragment shape. In the horizontal configuration, the step cut tibia developed the largest contact force to achieve stability of the bone fragment under loading. Conclusion: The fragment shape with a step cut and fixation with two parallel horizontal or downward screws are suggested for TTO, while the trapezoidal screw configuration is not suggested. Furthermore, the downward screw configuration is a suitable strategy to reduce bone stress. |
| first_indexed | 2024-12-11T00:42:46Z |
| format | Article |
| id | doaj.art-163d0f28f88c45899060a308a0b12fdc |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-11T00:42:46Z |
| publishDate | 2019-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-163d0f28f88c45899060a308a0b12fdc2022-12-22T01:26:52ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902019-07-012710.1177/2309499019861145Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomyChih-Wei Chang0Yen-Nien Chen1Chun-Ting Li2Chi-Rung Chung3Chih-Han Chang4Yao-Te Peng5 Department of Orthopedics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan City Department of Orthopedics, Show Chwan Memorial Hospital, Changhua City Graduate Institute of Mechatronic System Engineering, National University of Tainan, Tainan City Department of Orthopedics, Chi-Mei Medical Center, Tainan City Department of Biomedical Engineering, National Cheng Kung University, Tainan City Metal Industries Research & Development Centre, Kaohsiung CityPurpose: Tibial tubercle osteotomy (TTO) is a surgical technique used in the management of severe fractures of the knee joint and revision total knee arthroplasty. Limited research discusses the performance of the osteotomy and fixation of the TTO with screws. Therefore, this study investigated the effects of fragment shape and screw configuration on the mechanical behavior in the fixation of the TTO using the finite element (FE) method. Methods: FE TTO models with three fragment shapes and three screw configurations were developed. The three fragment shapes were a step cut, bevel cut, and straight cut. The screw configurations were two parallel horizontal and downward screws and two trapezoidal screws. A 1654-N upward tension force was applied on the tibia tubercle, and the distal end of the tibia was completely fixed. Results: The results indicated that the step cut resulted in higher stability than the bevel and straight cut, but the stress was higher as well. Among the screw configurations, two parallel downward screws resulted in the highest stability, given the same fragment shape. In the horizontal configuration, the step cut tibia developed the largest contact force to achieve stability of the bone fragment under loading. Conclusion: The fragment shape with a step cut and fixation with two parallel horizontal or downward screws are suggested for TTO, while the trapezoidal screw configuration is not suggested. Furthermore, the downward screw configuration is a suitable strategy to reduce bone stress.https://doi.org/10.1177/2309499019861145 |
| spellingShingle | Chih-Wei Chang Yen-Nien Chen Chun-Ting Li Chi-Rung Chung Chih-Han Chang Yao-Te Peng Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy Journal of Orthopaedic Surgery |
| title | Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| title_full | Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| title_fullStr | Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| title_full_unstemmed | Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| title_short | Finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| title_sort | finite element study of the effects of fragment shape and screw configuration on the mechanical behavior of tibial tubercle osteotomy |
| url | https://doi.org/10.1177/2309499019861145 |
| work_keys_str_mv | AT chihweichang finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy AT yennienchen finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy AT chuntingli finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy AT chirungchung finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy AT chihhanchang finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy AT yaotepeng finiteelementstudyoftheeffectsoffragmentshapeandscrewconfigurationonthemechanicalbehavioroftibialtubercleosteotomy |