Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies.
The medial closing-wedge distal femoral osteotomy (MCDFO) is an established medical procedure used to manage lateral compartment cartilage injuries, knee osteoarthritis (OA), and genu valgum (knock-knee). However, there is a high incidence of lateral hinge fracture (LHF) after MCDFO, resulting...
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| Format: | Final Year Project (FYP) |
| Language: | English |
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Nanyang Technological University
2024
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| Online Access: | https://hdl.handle.net/10356/177531 |
| _version_ | 1811687994917126144 |
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| author | Danieal Bin Ahmad |
| author2 | Chou Siaw Meng |
| author_facet | Chou Siaw Meng Danieal Bin Ahmad |
| author_sort | Danieal Bin Ahmad |
| collection | NTU |
| description | The medial closing-wedge distal femoral osteotomy (MCDFO) is an established medical
procedure used to manage lateral compartment cartilage injuries, knee osteoarthritis (OA), and
genu valgum (knock-knee). However, there is a high incidence of lateral hinge fracture (LHF)
after MCDFO, resulting in complications and loss of correction. The hypothesis proposes that
placing the hinge point lower, specifically beneath the metaphyseal flare can safeguard the
hinge against lateral hinge fracture, because of the metaphyseal bone's properties.
The objective of this study is to use finite element analysis on femur bone model with differing
hinge point locations and compare the results of maximum reaction forces, stiffness and area
of maximum stress distribution around the hinge point.
A finite element analysis was performed on a truncated femur bone model with differing hinge
point locations in increments of 10 mm starting from the lowest hinge possible. A singular
planar MCDFO was carried out at all the hinge points. A 10 mm remote displacement load is
applied from the bottom to simulate closing the wedge. The bone properties used remained
constant throughout the models for all hinge points.
Comparing all 5 hinge points, the low hinge point and 10 mm above the low hinge was able to
sustain the simulation without fracture. The remaining bone models fractured before the wedge
was fully closed. The reaction forces and stiffness increased with increasing hinge points. The
maximum stress distribution around the hinge point showed an increased in area with
increasing hinge points with the exception of the high hinge model.
This study found a trend suggesting the femur bone with MCDFO becomes more likely to
fracture with increasing hinge points suggesting that the lower hinge points should be
considered when conducting MCDFO as LHF are more likely to occur with incrementing hinge
points. |
| first_indexed | 2024-10-01T05:25:10Z |
| format | Final Year Project (FYP) |
| id | ntu-10356/177531 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:25:10Z |
| publishDate | 2024 |
| publisher | Nanyang Technological University |
| record_format | dspace |
| spelling | ntu-10356/1775312024-06-01T16:52:43Z Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. Danieal Bin Ahmad Chou Siaw Meng School of Mechanical and Aerospace Engineering MSMCHOU@ntu.edu.sg Engineering Medicine, Health and Life Sciences Medial closing-wedge distal femoral osteotomy MCDFO Lateral hinge fracture LHF Knee osteoarthritis Finite element analysis FEA The medial closing-wedge distal femoral osteotomy (MCDFO) is an established medical procedure used to manage lateral compartment cartilage injuries, knee osteoarthritis (OA), and genu valgum (knock-knee). However, there is a high incidence of lateral hinge fracture (LHF) after MCDFO, resulting in complications and loss of correction. The hypothesis proposes that placing the hinge point lower, specifically beneath the metaphyseal flare can safeguard the hinge against lateral hinge fracture, because of the metaphyseal bone's properties. The objective of this study is to use finite element analysis on femur bone model with differing hinge point locations and compare the results of maximum reaction forces, stiffness and area of maximum stress distribution around the hinge point. A finite element analysis was performed on a truncated femur bone model with differing hinge point locations in increments of 10 mm starting from the lowest hinge possible. A singular planar MCDFO was carried out at all the hinge points. A 10 mm remote displacement load is applied from the bottom to simulate closing the wedge. The bone properties used remained constant throughout the models for all hinge points. Comparing all 5 hinge points, the low hinge point and 10 mm above the low hinge was able to sustain the simulation without fracture. The remaining bone models fractured before the wedge was fully closed. The reaction forces and stiffness increased with increasing hinge points. The maximum stress distribution around the hinge point showed an increased in area with increasing hinge points with the exception of the high hinge model. This study found a trend suggesting the femur bone with MCDFO becomes more likely to fracture with increasing hinge points suggesting that the lower hinge points should be considered when conducting MCDFO as LHF are more likely to occur with incrementing hinge points. Bachelor's degree 2024-05-29T06:53:59Z 2024-05-29T06:53:59Z 2024 Final Year Project (FYP) Danieal Bin Ahmad (2024). Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies.. Final Year Project (FYP), Nanyang Technological University, Singapore. https://hdl.handle.net/10356/177531 https://hdl.handle.net/10356/177531 en application/pdf Nanyang Technological University |
| spellingShingle | Engineering Medicine, Health and Life Sciences Medial closing-wedge distal femoral osteotomy MCDFO Lateral hinge fracture LHF Knee osteoarthritis Finite element analysis FEA Danieal Bin Ahmad Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title | Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title_full | Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title_fullStr | Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title_full_unstemmed | Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title_short | Biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies. |
| title_sort | biomechanical advantage of low lateral hinge location in medial closing wedge distal femoral osteotomies |
| topic | Engineering Medicine, Health and Life Sciences Medial closing-wedge distal femoral osteotomy MCDFO Lateral hinge fracture LHF Knee osteoarthritis Finite element analysis FEA |
| url | https://hdl.handle.net/10356/177531 |
| work_keys_str_mv | AT daniealbinahmad biomechanicaladvantageoflowlateralhingelocationinmedialclosingwedgedistalfemoralosteotomies |