Finite Element Analysis of Sacroiliac Joint Fixation under Compression Loads

Bruna-Rosso, Claire; Arnoux, Pierre‐Jean; Bianco, Rohan-Jean; Godio‐Raboutet, Yves; Fradet, Léo; Aubin, Carl‐Éric

doi:10.14444/3016

Cited by 42 publications

(48 citation statements)

References 32 publications

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“…The application of FE research has extended beyond investigating healthy and pathologically-altered biomechanics into engineering science, where developing and validating surgical implants as a potential treatment option becomes increasingly important. This relates to FE models of healthy load distribution (Eichenseer et al, 2011;Hammer et al, 2013), pelvic injury García et al, 2000), diagnostics around the painful SIJ (Kiapour et al, 2012;Kim et al, 2014), as well as nonsurgical (Sichting et al, 2014) and surgical (Böhme et al, 2012;Bruna-Rosso et al, 2016;Kurz et al, 2017;Lindsey et al, 2015) treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This is partly caused by the paucity in accurate load deformation data, which can be used for assessing the validity of computationally observed movements. Similarly, existent FE models are commonly limited to the pelvic ring, and exclude the lumbosacral transition (Böhme et al, 2012;Böhme et al, 2014;Bruna-Rosso et al, 2016;Eichenseer et al, 2011;García et al, 2000;Hammer et al, 2013;Kurz et al, 2017) or even the sacrum (Anderson et al, 2004;Phillips et al, 2007b)structures known to vastly govern pelvis and SIJ motion.…”

Section: Discussionmentioning

confidence: 99%

“…One limitation most FE models have in common is their lack of performing an in-vivo or in-vitro validation or that no validation is performed beyond a comparison to literature to substantiate their findings (Böhme et al, 2012;Eichenseer et al, 2011;Kim et al, 2014;Kurz et al, 2017;Sichting et al, 2014;Watson et al, 2017). Equally, minute sample sizes (Bruna-Rosso et al, 2016;Shi et al, 2014) for validation or non-physiological loading conditions with rigidly-fixed innominate bones (Bruna-Rosso et al, 2016) lower the significance of existing studies, including our own previous findings, as in-silico deformations vary by up to two magnitudes comparing the evident movement to the in-silico models (Hammer et al, 2013;Sichting et al, 2014). Of the 33 computational studies of the pelvis, only seven make an attempt to perform a cadaveric validation in a standardized manner (Anderson et al, 2004;Bodzay et al, 2014;Bruna-Rosso et al, 2016;García et al, 2000;Hammer et al, 2013;Hao et al, 2011;Hu et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Mechanisms involved in injury have been the focus of the studies by Böhme et al (2014), Lei et al (2015) and Sztrinkai et al (2014). Surgical stabilization for the treatment of pelvic injury have been addressed by many studies Bruna-Rosso et al, 2016;Fu et al, 2014;García et al, 2000;Lee et al, 2017;Wang et al, 2013;Zhang et al, 2014;Zhao et al, 2012). For this purpose, metal plates, screws, sacral bars and external fixators were included in models.…”

Section: Scope Of Fe Analyses Focusing On Surgical Interventionmentioning

confidence: 99%

“…Virtual computational models of the human pelvis have evolved as highly useful tools to assess load distribution under healthy conditions, as well as pathologically altered biomechanics (Anderson et al, 2004;Böhme et al, 2014;Bruna-Rosso et al, 2016;Eichenseer et al, 2011;Hammer et al, 2013;Hao et al, 2011;Kim et al, 2014;Phillips et al, 2007b;Shi et al, 2014;Watson et al, 2017), and to evaluate the effects of both non-surgical (Sichting et al, 2014) and surgical treatment (Böhme et al, 2012;García et al, 2000;Kurz et al, 2017). The finite elements (FE) method is commonly utilized for this purpose.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Hammer

Klima

2019

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Scope Of Fe Analyses Focusing On Surgical Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Hammer

Klima

2019

Clinical Biomechanics

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A systematic review of the morphology and function of the sacrotuberous ligament

et al. 2019

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The sacrotuberous ligament (STL) has been linked to conditions such as pelvic girdle pain and pudendal nerve entrapment, yet its contribution to pelvic stability is debated. The purpose of this review was to explore the current understanding of the STL and highlight any gaps in knowledge regarding its anatomy and function. A systematic search of the literature was conducted, focussing on the morphology and attachments of the STL, the relationship of the STL with surrounding structures, and its neurovascular supply and function. A total of 67 papers and four textbooks were obtained. The attachment sites of the STL are largely consistent; however, the extent of its connections with the long head of biceps femoris, gluteus maximus, piriformis, the posterior layer of the thoracolumbar fascia, and sacrospinous ligament are unclear. Morphometric parameters, such as mean STL length (6.4-9.4 cm), depth (0.3-0.4 cm), and width (1.8-3.5 cm, at its midpoint) are variable within and between studies, and little is known about potential side-, age-, or sex-related differences. The STL is pierced in several sites by the inferior and superior gluteal arteries, but information on its innervation pattern is sparse. Functionally, the STL may limit sacral nutation but it appears to have a limited contribution to pelvic stability. Some morphological aspects of the STL warrant further investigation, particularly its connections with surrounding structures, innervation pattern and function. Knowledge of the detailed anatomy and function of this ligament is important to better understanding its role in clinical conditions. Clin. Anat. 32:396-407, 2019.

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Instrumentation of the sacroiliac joint with cylindrical threaded implants: A detailed finite element study of patient characteristics affecting fixation performance

Dubé-Cyr

Villemure

Arnoux

et al. 2021

Journal Orthopaedic Research

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The sacroiliac joint (SIJ) is a known pain generator that, in severe cases, may require surgical fixation to reduce intra-articular displacements and allow for arthrodesis.The objective of this computational study was to analyze how the number of implants affected SIJ stabilization with patient-specific characteristics such as the pelvic geometry and bone quality. Detailed finite element models were developed to account for three pelvises of differing anatomy. Each model was tested with a normal and low bone density (LD) under two types of loading: compression only and compression with flexion and extension moments. These models were instrumented with one to three cylindrical, threaded and fenestrated implants through a posterior oblique trajectory, requiring less muscle dissection than the more common lateral trajectory used with triangular implants. Compared with the noninstrumented pelvis, the change in range of motion (ROM) and stress distribution were used to characterize joint stabilization. Noninstrumented mobility ranged from 0.86 to 2.55 mm and from 1.37°to 6.11°. Across patient-specific characteristics, the ROM reduction with one implant varied from 3% to 21% for vertical and 15% to 47% for angular displacements. With two implants, the ROM reduction ranged from 12% to 41% for vertical and from 28% to 61% for angular displacements. Three implants, however, did not further improve the joint stability (14% to 42% for vertical and 32% to 63% for angular displacements). With respect to patient characteristics, an LD led to a decreased stabilization and a higher volume of stressed bone (>75% of yield stress). A better understanding of how patient characteristics affect the implant performance could help improve surgical planning of sacroiliac arthrodesis.

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Finite Element Analysis of Sacroiliac Joint Fixation under Compression Loads

Abstract: Knowledge provided by this biomechanical study enables improvement of SIJ fixation through optimal implant trajectory.

Cited by 42 publications

References 32 publications

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

A systematic review of the morphology and function of the sacrotuberous ligament

Instrumentation of the sacroiliac joint with cylindrical threaded implants: A detailed finite element study of patient characteristics affecting fixation performance

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