Novel implant for peri-prosthetic proximal tibia fractures.

Background: Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has...

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Publicado en:Injury Vol. 49; no. 3; pp. 705 - 712
Autores principales: Tran, Ton, Chen, Bernard K, Wu, Xinhua, Pun, Chung Lun
Formato: case study Journal Article
Publicado: Elsevier B.V. Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
      vid: 49
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      pub: Elsevier B.V.
      place: New York, New York
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        129011967
        129011967
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        10.1016/j.injury.2018.01.032
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        129011967
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        atl: Novel implant for peri-prosthetic proximal tibia fractures.
      aug:
        au:
          Tran, Ton
          Chen, Bernard K
          Wu, Xinhua
          Pun, Chung Lun
        affil: Department of Materials Science and Engineering, Monash University, Clayton, VIC 3800, Australia
      sug:
        subj:
          Fractures Surgery
          Fracture Fixation Methods
          Printing, Three-Dimensional
          Knee Joint Surgery
          Tibial Fractures Surgery
          Arthroplasty, Replacement, Knee Adverse Effects
          Joint Prosthesis
          Treatment Outcomes
          Aged
          Tomography, X-Ray Computed
          Fractures
          Fractures Physiopathology
          Prosthesis Design
          Knee Joint Physiopathology
          Female
          Knee Joint
          Aged: 65+ years
          Female
      ab: Background: Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has been designed with an extended flange over the anterior of tibial condyle to provide additional points of fixation, overcoming limitations of existing generic locking plates used for proximal tibia fractures. Furthermore, the screws fixed through the extended flange provide additional support to prevent the problem of subsidence of tibial component of knee implant.Methods: The design methodology involved extraction of bone data from CT scans into a flexible CAD format, implant design and structural evaluation and optimisation using FEM as well as prototype development and manufacture by selective laser melting 3D printing technology with Ti6Al4 V powder.Results: A prototype tibia implant was developed based on a patient-specific bone structure, which was regenerated from the CT images of patient's tibia. The design is described in detail and being applied to fit up to 80% of patients, for both left and right sides based on the average dimensions and shape of the bone structure from a wide range of CT images.Conclusion: A novel tibial implant has been developed to repair peri-prosthetic proximal tibia fractures which overcomes significant constraints from the tibial component of existing knee implant.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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