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Backgrounds: Despite the use of a locking plate a 30% incidence of lateral hinge fracture after Open-Wedge High Tibial Ostetomy was described in the literature.A finite element model was used to analyze if the presence of a hinge-securing screw in the osteotomy area, using Patient Specific Cutting Guides with a locking plate, decreases the stresses within the lateral hinge during compression and torsion. Methods: A 3D model of a tibial sawbone was used to simulate an opening wedge of 10°. To apply loads on the tibial plateau, two supports were modelled on each tibial plateau to simulate the femoral condyles forces. A two second model with a hinge-stabilizing was defined with two different screws (diameter 2 mm and 4 mm). Two cases of static charges were considered 1) compression test (2500 N) 2) Torsion test (along the tibial mechanical axis). Findings: During compression simulation, 17% of the total surface of lateral hinge was stressed between 41-50Mpa without hinge-securing screw while the amount of surface under stress between 41 and 50 MPa dropped significantly under screw stabilization (1% for the 2 mm and 3% for the 4 mm).During torsion stress simulation a decrease of the value of the maximal stress in the lateral hinge was also observed with the addition of a hinge-securing screw (37 MPa without screw, 27Mpa with a 2 mm screw and 25 Mpa with a 4 mm screw). Interpretation: Positioning a screw intersecting the cutting plane at the theoretical lateral hinge location associated with a locking plate reduces lateral hinge stress in both compression and torsion. Those findings need to be confirmed by further specimens' mechanical testing.

Cholangiocytes, biliary epithelial cells, are known to spontaneously self-organize into spherical cysts with a central lumen. In this work, we explore a promising biocompatible stereolithographic approach to encapsulate cholangiocytes into geometrically-controlled 3D hydrogel structures to guide them towards the formation of branched tubular networks. We demonstrate that within the appropriate mix of hydrogels, normal rat cholangiocytes can proliferate, migrate and organize into branched tubular structures, form walls consisting of a cell monolayer, transport fluorescent dyes into the luminal space and show markers of epithelial maturation such as primary cilia. The resulting structures have dimensions typically found in the intralobular and intrahepatic bile ducts and are stable for weeks, without any requirement of bulk supporting material, thereby offering total access to the basal side of these biliary epithelial constructs.