Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities
Introduction: Correction of knee malalignment by guided growth using a tension-band plate is a common therapy to prevent knee osteoarthritis among other things. This approach is based on the Hueter-Volkmann law stating that the length growth of bones is inhibited by compression and stimulated by ten...
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1165963/full |
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| author | Lucie Hucke Lucie Hucke Jana Holder Stefan van Drongelen Stefan van Drongelen Felix Stief Felix Stief Antonio J. Gámez Armin Huß Andreas Wittek |
| author_facet | Lucie Hucke Lucie Hucke Jana Holder Stefan van Drongelen Stefan van Drongelen Felix Stief Felix Stief Antonio J. Gámez Armin Huß Andreas Wittek |
| author_sort | Lucie Hucke |
| collection | DOAJ |
| description | Introduction: Correction of knee malalignment by guided growth using a tension-band plate is a common therapy to prevent knee osteoarthritis among other things. This approach is based on the Hueter-Volkmann law stating that the length growth of bones is inhibited by compression and stimulated by tension. How the locally varying mechanical loading of the growth plate is influenced by the implant has not yet been investigated. This study combines load cases from the gait cycle with personalized geometry in order to investigate the mechanical influence of the tension-band plates.Methods: Personalized finite element models of four distal femoral epiphyses of three individuals, that had undergone guided growth, were generated. Load cases from the gait cycles and musculoskeletal modelling were simulated with and without implant. Morphological features of the growth plates were obtained from radiographs. 3D geometries were completed using non-individual Magnetic Resonance Images of age-matched individuals. Boundary conditions for the models were obtained from instrumented gait analyses.Results: The stress distribution in the growth plate was heterogenous and depended on the geometry. In the insertion region, the implants locally induced static stress and reduced the cyclic loading and unloading. Both factors that reduce the growth rate. On the contralateral side of the growth plate, increased tension stress was observed, which stimulates growth.Discussion: Personalized finite element models are able to estimate the changes of local static and cyclic loading of the growth plate induced by the implant. In future, this knowledge can help to better control growth modulation and avoid the return of the malalignment after the treatment. However, this requires models that are completely participant-specific in terms of load cases and 3D geometry. |
| first_indexed | 2024-03-13T04:03:53Z |
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| language | English |
| last_indexed | 2024-03-13T04:03:53Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-1bd82ddef68e48cca1e981c014dc97622023-06-21T09:53:45ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852023-06-011110.3389/fbioe.2023.11659631165963Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformitiesLucie Hucke0Lucie Hucke1Jana Holder2Stefan van Drongelen3Stefan van Drongelen4Felix Stief5Felix Stief6Antonio J. Gámez7Armin Huß8Andreas Wittek9Peronalized Biomedical Engineering Laboratory, Frankfurt University of Applied Sciences, Frankfurt am Main, GermanyDepartment of Mechanical Engineering and Industrial Design, School of Engineering, University of Cádiz, Cádiz, SpainDepartment of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Mechanical Engineering and Industrial Design, School of Engineering, University of Cádiz, Cádiz, SpainPeronalized Biomedical Engineering Laboratory, Frankfurt University of Applied Sciences, Frankfurt am Main, GermanyPeronalized Biomedical Engineering Laboratory, Frankfurt University of Applied Sciences, Frankfurt am Main, GermanyIntroduction: Correction of knee malalignment by guided growth using a tension-band plate is a common therapy to prevent knee osteoarthritis among other things. This approach is based on the Hueter-Volkmann law stating that the length growth of bones is inhibited by compression and stimulated by tension. How the locally varying mechanical loading of the growth plate is influenced by the implant has not yet been investigated. This study combines load cases from the gait cycle with personalized geometry in order to investigate the mechanical influence of the tension-band plates.Methods: Personalized finite element models of four distal femoral epiphyses of three individuals, that had undergone guided growth, were generated. Load cases from the gait cycles and musculoskeletal modelling were simulated with and without implant. Morphological features of the growth plates were obtained from radiographs. 3D geometries were completed using non-individual Magnetic Resonance Images of age-matched individuals. Boundary conditions for the models were obtained from instrumented gait analyses.Results: The stress distribution in the growth plate was heterogenous and depended on the geometry. In the insertion region, the implants locally induced static stress and reduced the cyclic loading and unloading. Both factors that reduce the growth rate. On the contralateral side of the growth plate, increased tension stress was observed, which stimulates growth.Discussion: Personalized finite element models are able to estimate the changes of local static and cyclic loading of the growth plate induced by the implant. In future, this knowledge can help to better control growth modulation and avoid the return of the malalignment after the treatment. However, this requires models that are completely participant-specific in terms of load cases and 3D geometry.https://www.frontiersin.org/articles/10.3389/fbioe.2023.1165963/fullgrowth plateguided growthfinite element analysisknee modeltension-band platestress distribution |
| spellingShingle | Lucie Hucke Lucie Hucke Jana Holder Stefan van Drongelen Stefan van Drongelen Felix Stief Felix Stief Antonio J. Gámez Armin Huß Andreas Wittek Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities Frontiers in Bioengineering and Biotechnology growth plate guided growth finite element analysis knee model tension-band plate stress distribution |
| title | Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| title_full | Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| title_fullStr | Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| title_full_unstemmed | Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| title_short | Influence of tension-band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| title_sort | influence of tension band plates on the mechanical loading of the femoral growth plate during guided growth due to coronal plane deformities |
| topic | growth plate guided growth finite element analysis knee model tension-band plate stress distribution |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1165963/full |
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