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Design Principles to Increase the Patient Specificity of High Tibial Osteotomy Fixation Devices

Published online by Cambridge University Press:  26 July 2019

Sanjeevan Kanagalingam*
Affiliation:
School of Engineering, University of Birmingham, UK;
Duncan Shepherd
Affiliation:
School of Engineering, University of Birmingham, UK;
Miguel Fernandez-Vicente
Affiliation:
Manufacturing Technology Centre, Coventry, UK
David Wimpenny
Affiliation:
Manufacturing Technology Centre, Coventry, UK
Lauren Thomas-Seale
Affiliation:
School of Engineering, University of Birmingham, UK;
*
Contact: Kanagalingam, Sanjeevan, University Of Birmingham, Mechanical Engineering, United Kingdom, [email protected]

Abstract

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High stiffness fracture fixation devices inducing absolute stability, activate inefficient primary healing and stress shielding. Taking High Tibial Osteotomy as a representative example, review of the clinical literature and mapping the fracture healing process revealed two physically contradicting requirements, which are only partially met by current techniques. Stiffness of the fixation is required immediately after fracture, however in the remodelling phase this can cause stress shielding. Stability is required immediately after fracture, however in the ossification phase less stability is required to stimulate secondary (and more efficient) healing. This study evaluates the use of the TRIZ Inventive Design Principles to overcome these physical contradictions. Six designs concepts were evaluated, of which the Macro-Geometry stiffness modulated design was ranked the highest. This was achieved through spatial decomposition of the problem utilising the Inventive Principles of Asymmetry, Extraction and Local Quality. This study offer perspectives on how to increase the patient specificity of fixation utilising the increased topology freedom of design for additive manufacture (AM).

Type
Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s) 2019

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