This paper provides an analysis from a biomechanical perspective of the medial opening wedge high tibial osteotomy surgery, a medical procedure commonly used in treating knee osteoarthritis. The aim of this research is to improve the analysed surgical strategy by establishing optimal values for several very important parameters for the geometric planning of this type of surgical intervention. The research methods used are numerical and experimental. We used finite element, a numerical method used to study the intraoperative behavior of the CORA area for different positions of the initiation point of the cut of the osteotomy plane and for different correction angles. We also used an experimental method in order to determine the maximum force which causes the occurrence of cracks or microcracks in the CORA area. This helped us to determine the stresses, the maximum forces, and the force-displacement variations in the hinge area, elements that allowed us to identify the optimal geometric parameters for planning the surgery.
The presented article is an original contribution which implies the design of a specialized device for high tybial osteotomy (HTO) optimization. In the papers are presented the sources that imply HTO, the axial deviations of the human lower member from the correct position. This sources are the gonarthosys owed to the usage of the knees cartilages or owed to some diseases (such as the Blount disease) and the vicious consolidated fractures. After presenting the needs to realize such a specialized device for HTO, the principal requests the device shall fulfill are underlined. Starting from these , two sub ensembles were projected, one for the tibial positioning and for the execution of the hole from the center of rotation of angulation (CORA), and the second one for the realization of the cuts. Both sub ensembles have been 3D modeled in Catia V5R20. The model was designed mounted on the bone.
Given the complex form of the long bones, a quality method of geometrical modeling which provides a good result is that of the 3D modeling by reconstruction, using the principles of reverse engineering. One of the important problems that shall be taken into consideration while modeling is the one concerning the real structure of the bones. This aspect presents a lot of importance because from the point of view of the mechanical behavior, the bones are neither homogenate structures. In this paper a study of the long bones structures is undergone, and in relation to the modelated element (the human tibia) it is divided in areas (called constructive-anatomical entities) of different mechanical characteristics and in consequence of this they are being modelated in 3D.
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