This paper provides an analysis from a biomechanical perspective of the medial opening wedge high tibial osteotomy surgery, a medical procedure commonly used in treating knee osteoarthritis. The aim of this research is to improve the analysed surgical strategy by establishing optimal values for several very important parameters for the geometric planning of this type of surgical intervention. The research methods used are numerical and experimental. We used finite element, a numerical method used to study the intraoperative behavior of the CORA area for different positions of the initiation point of the cut of the osteotomy plane and for different correction angles. We also used an experimental method in order to determine the maximum force which causes the occurrence of cracks or microcracks in the CORA area. This helped us to determine the stresses, the maximum forces, and the force-displacement variations in the hinge area, elements that allowed us to identify the optimal geometric parameters for planning the surgery.
This article presents an experimental approach to the geometrical planning of the medial opening wedge high tibial osteotomy surgery which, as it is known, is an efficient surgical strategy quite widely used in treating knee osteoarthritis. While most of the published papers focus on analyzing this surgery from a medical point of view, we suggest a postoperative experimental evaluation of the intervention from a biomechanical point of view. The geometrical planning and, more specifically, the determination of the point of intersection between the corrected mechanical axis and the medial-lateral articular line of the knee, is a problem quite often debated in literature. This paper aims to experimentally investigate the behavior of the tibia with an open wedge osteotomy fixed with a locking plate, TomoFix (DE Puy Synthes), taking into account two positions of the mechanical axis of the leg on the width of the tibial plateau, measured from medial to lateral at 50% and 62.5% (Fujisawa point), respectively. The variations of the force relative to the deformation, strains, and displacements resulting from the progressive loading of the tibial plateau are studied. The research results reveal that using the Fujisawa point is better for conducting the correction not only for medical reasons, but also from a mechanical point of view.
Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure often used to eliminate the effects of knee osteoarthritis, a disease that is becoming more widespread worldwide. Optimizing the geometric planning of this operation is a very important preparatory step for the success of the intervention and rapid postoperative recovery. This optimization is performed in two main directions. The first direction evaluates the intraoperative behavior of the tibia during the osteotomy by optimizing four geometric parameters that characterize geometric planning. The second direction aims at a postoperative evaluation of the flat tibia-osteosynthesis assembly taking into account the optimal position on the medial–lateral articular line through which the corrected mechanical axis of the tongue passes and implicitly offloads the transfer from the medial area to the side of the knee. The research methods used are exclusively computer-assisted such as: computer-aided design (hereinafter CAD) for geometric modeling of the tibia taking into account the real bone structure, the finite element method (hereinafter FEM) for performing numerical analyses and design of the experiment (hereinafter DOE) for the design of the research. The results obtained are eloquent and clearly presented and can be important elements for orthopedic doctors at the geometric planning stage of the OWHTO.
1 December 2019 in Acta Universitatis Cibiniensis. Technical Series
The paper is an interdisciplinary medical and engineering approach that aims to optimize the accuracy of the High Tibial Osteotomy surgical intervention. The axial deviations of the human inferior limb are presented in the first part of the paper. Without altering the shape of the bones, these deviations cause the wear of the knee’s articular cartilage by gonarthrosis. One of the most common and effective treatment modalities for eliminating axial deviations is High Tibial Osteotomy. Because the surgical procedure involves 3D spatial bone cutting, the accuracy of the procedure and thus the success of the operation and the recovery of the patient is dependent on the execution of these cuts. Within this paper, a specialized device is proposed that makes it possible to guide the surgical saw and to accurately perform the correction angles. In the last part of the paper, customization possibilities and fabrication of the main elements of the cutting device using Additive Manufacturing processes are presented.
20 December 2017 in ACTA Universitatis Cibiniensis
The study shown in this paper presents the behavior of geomembranes used at the ecological landfills. The influences of the solar radiations has a great importance regarding the correct mounting of the geomembranes. The mathematical model developed for the determination anytime and anywhere in the world for the next values and parameters: apparent solar time, solar declination, solar altitude, solar azimuth and incidence angle, zone angle, angle of sun elevation, solar declination, solar constant, solar flux density, diffuse solar radiation, global radiation, soil albedo, total radiant flux density and relational links of these values. The results of this model was used for creations an AutoCAD subroutines useful for choosing the correct time for correct mounting anywhere of the geomembranes