Nada Raafat Khattab, Luis H Olivas-Alanis, Agnieszka Chmielewska-Wysocka, Hany Emam, Ryan Brune, Ahmadreza Jahadakbar, Sahil Khambhampati, Joseph Lozier, Keyvan Safaei, Roman Skoracki, Mohammad Elahinia, David Dean
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引用次数: 0
Abstract
Background: Manually bent, standard-of-care, Ti-6Al-4V, mandibular graft fixation devices are associated with a significant post-operative failure rate. These failures require the patient to endure stressful and expensive re-operation. The approach recommended in this report demonstrates the optimization of graft fixation device mechanical properties via "stiffness-matching" by varying the fixation device's location, shape, and material composition through simulation of the device's post-operative performance. This provides information during pre-operative planning that may avoid future device failure. Optimized performance may combine translation of all loading into compression of the bone graft with the adjacent bone segments and elimination or minimization of post-healing interruption of normal stress-strain (loading) trajectories.
Results: This study reports a sheep mandibular graft model where four animals received virtually optimized, experimental nickel-titanium (NiTi) fixation plates fabricated using laser beam powder bed fusion (LPBF) additive manufacturing (AM). The last animal, our control, received a standard-of-care, manually bent, Ti-6Al-4V (aka Ti64) fixation plate. A 17.5-mm mandibular graft healed completely in all four animals receiving the experimental device. Experimental NiTi-implanted sheep experienced mandibular bone healing and restoration. The Ti64 plate, in the control animal, fractured and dislocated shortly after being implanted.
Conclusion: The use of stiffness-matched implants, by means of plate material (NiTi) and geometry (porosity) enhanced bone healing and promoted better load transfer to the healed bone when compared to the bulk Ti64 found in the fixation plate that the Control animal received. The design technique and screw orientation and depth planning improved throughout the study leading to more rapid healing. The large animal model reported here provides data useful for a follow-on clinical trial.
期刊介绍:
BioMedical Engineering OnLine is an open access, peer-reviewed journal that is dedicated to publishing research in all areas of biomedical engineering.
BioMedical Engineering OnLine is aimed at readers and authors throughout the world, with an interest in using tools of the physical and data sciences and techniques in engineering to understand and solve problems in the biological and medical sciences. Topical areas include, but are not limited to:
Bioinformatics-
Bioinstrumentation-
Biomechanics-
Biomedical Devices & Instrumentation-
Biomedical Signal Processing-
Healthcare Information Systems-
Human Dynamics-
Neural Engineering-
Rehabilitation Engineering-
Biomaterials-
Biomedical Imaging & Image Processing-
BioMEMS and On-Chip Devices-
Bio-Micro/Nano Technologies-
Biomolecular Engineering-
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Nanomaterials and Nanotechnology in Biomedicine-
Respiratory Systems Engineering-
Robotics in Medicine-
Systems and Synthetic Biology-
Systems Biology-
Telemedicine/Smartphone Applications in Medicine-
Therapeutic Systems, Devices and Technologies-
Tissue Engineering