In vitro assessment of the contact mechanics of reverse-engineered distal humeral hemiarthroplasty prostheses

Willing, Ryan; Lapner, Michael; King, Graham J.W.; Johnson, James A.

doi:10.1016/j.clinbiomech.2014.08.015

Cited by 16 publications

(13 citation statements)

References 23 publications

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“…13,14 The recent biomechanic study in the cadaveric arms demonstrated that the reverse-engineered distal humeral hemiarthroplasty prostheses did not reproduce the same contact pattern as the native joints, possibly because the prostheses were designed based on distal humeral osseous anatomy from the CT images which is lacked inclusion of the cartilage thickness. 15 For this reason, the authors utilized an osteochondral fragment of the capitellum which was obtained from the surgical debridement to guide for the appropriate morphologic shape and dimension of the surface of the articular portion. Intraoperatively, the conforming surface of the implant with the native bone facilitated the intraoperative placement and aided for accurate positioning.…”

Section: Discussionmentioning

confidence: 99%

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Luenam

Kosiyatrakul

Phakdeewisetkul

et al. 2020

J Orthop Surg (Hong Kong)

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The open distal humeral fracture associated with the major loss of the articular surface and bony structure is a challenging problem for orthopedic surgeons. In this case report, we describe a case of complete missing lateral column of the distal humerus with severe articular destruction of capitellum and lateral trochlear ridge which was treated with the patient-specific implant created with three-dimensional printing technology. Apart from anatomic replacement of the articular surface, the lateral collateral ligament complex and extensor muscle which are the key soft tissue stabilizers of elbow were repaired by reattaching their bony origins to the impacted iliac crest bone graft inside the implant. Due to the favorable result at 2-year follow-up, this modality is a potentially viable surgical option in treating of the severe open distal humeral fracture associated with entire lateral condylar damage.

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Section: Discussionmentioning

confidence: 99%

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Luenam

Kosiyatrakul

Phakdeewisetkul

et al. 2020

J Orthop Surg (Hong Kong)

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“…Loads and boundary conditions were applied to the FE elbow joint models to simulate natural flexion of the joint. The values of these loads and load locations were selected in accordance with previously published studies [ 23 – 25 ]. To stabilize the elbow joint, constant muscle strength values of 40, 20 and 20 N (at ratios designed to balance flexion and extension moments across the joint) were attached to the bases of triceps, biceps and brachial muscle tendons, respectively, oriented parallel to the axis of the humerus (Fig.…”

Section: Methodsmentioning

confidence: 99%

Comparative Biomechanical Analysis of Stress–Strain State of the Elbow Joint After Displaced Radial Head Fractures

et al. 2017

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Radial head fractures are becoming a major public health problem and are an increasingly important target for both clinical and mechanical researchers. In this work, comparative biomechanical analyses of the stress–strain state of a healthy elbow joint and elbow joints with radial head compression from 2 to 5 mm due to injury are performed. Three-dimensional models of the elbow joint with cartilage surfaces and ligaments were constructed based on the results of computed tomography. This study is focused on an elbow joint range of motion ranging from 0° to 120° flexion. Analysis of the stress–strain state of cartilage and ligaments under the influence of functional loads is conducted using a finite element method (FEM) and the ABAQUS software package. The results show that with increasing compression of the radial head, contact stress increases at the olecranon, which can lead to cartilage damage. Analysis of displacement shows that compression of the radial head during full extension of the elbow joint leads to an increased humeral shift from 1.14° ± 0.22 in the healthy joint to 10.3° ± 2.13 during 5-mm compression of the radial head. Mathematical modeling performed in this study proved that reducing the height of the radial head and the contact area between the radial head and the humeral head led to increased medial collateral ligament stresses of up to 36 ± 3.8 MPa. This work confirmed that the head of the radius is the main stabilizing structure of the elbow joint and that the medial collateral ligament is the second structure responsible for valgus stability of the elbow joint.

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“…Computed tomography (CT) scans of each fresh frozen cadaveric elbow specimen were performed using a GE Discovery CT750 HD scanner (GE Health Care, Pewaukee, WI, USA) at 120 kV and 292 mAs with a slice thickness of 0.625 mm (in-plane pixel sizes ranging from 0.492 -0.586 mm). The CT data was imported into Mimics v14.12 (Materialise, Leuven, Belgium), and the distal humeral bone geometry was extracted using threshold based segmentation, which included any voxel with an attenuation value of 250 HU or greater 5,23,25 . These threedimensional models were wrapped, exported in the stereolithography (STL) format, and remeshed using a radial basis function in Matlab (The Mathworks, Natick, MA, USA).…”

Section: Reverse-engineered Implant Designmentioning

confidence: 99%

“…A Boolean geometry subtract operation was performed using custom Blender script (The Blender Foundation, Amsterdam, NL), which cropped the model to the articular region and created interface geometry for attaching an existing custom humeral stem component. Stainless steel prosthesis prototypes based on these computer models were manufactured using a sPro TM 125 direct metal selective laser melting (SLM) machine (3D Systems Corp., Rock Hill, SC, USA), and polished until a smooth mirror-like finish was obtained on the articular surfaces of the prosthesis 23 .…”

Section: Reverse-engineered Implant Designmentioning

confidence: 99%

“…We postulate that DH implant positioning could be playing an important role. While changes in elbow contact patterns after DHH throughout simple flexion-extension motions have been investigated 23 , changes in contact patterns through positioning at varying varus-valgus (VV) angulations have not. We believe that positioning changes load transmission across the elbow, and could have long-term implications on cartilage wear.…”

Section: Introductionmentioning

confidence: 99%

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An In Vitro Study of the Role of Implant Positioning on Ulnohumeral Articular Contact in Distal Humeral Hemiarthroplasty

Abhari

Willing

King

et al. 2017

The Journal of Hand Surgery

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In vitro assessment of the contact mechanics of reverse-engineered distal humeral hemiarthroplasty prostheses

Cited by 16 publications

References 23 publications

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

The patient-specific implant created with 3D printing technology in treatment of a severe open distal humerus fracture with complete loss of the lateral column

Comparative Biomechanical Analysis of Stress–Strain State of the Elbow Joint After Displaced Radial Head Fractures

An In Vitro Study of the Role of Implant Positioning on Ulnohumeral Articular Contact in Distal Humeral Hemiarthroplasty

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