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      Evaluating the validity of lightweight talar replacement designs: rational models and topologically optimized models

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      https://www.riss.kr/link?id=A108504683

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      Background: Total talar replacement is normally stable and satisfactory. We studied a rational scaffold talus model for each size range created through topology optimization (TO) and comparatively evaluated a topologically optimized scaffold bone talus model using a finite element analysis (FEA). We hypothesized that the rational scaffold would be more effective for application to the actual model than the topologically optimized scaffold. Methods: Size specification for the rational model was performed via TO and inner scaffold simplification. The load condition for worst-case selection reflected the peak point according to the ground reaction force tendency, and the load directions “plantar 10°” (P10), “dorsi 5°” (D5), and “dorsi 10°” (D10) were applied to select worst-case scenarios among the P10, D5, and D10 positions (total nine ranges) of respective size specifications. FEA was performed on each representative specification-standard model, reflecting a load of 5340 N. Among the small bone models selected as the worst-case, an arbitrary size was selected, and the validity of the standard model was evaluated. The standard model was applied to the rational structure during validity evaluation, and the TO model reflecting the internal structure derived by the TO of the arbitrary model was implemented. Result: In worst-case selection, the highest peak von Mises stress (PVMS) was calculated from the minimum D5 model (532.11 MPa). Thereafter, FEA revealed peak von Mises stress levels of 218.01 MPa and 565.35 MPa in the rational and topologically optimized models, respectively, confirming that the rational model yielded lower peak von Mises stress. The weight of the minimum model was reduced from 1106 g to 965.4 g after weight reduction through rational scaffold application. Conclusion: The rational inner-scaffold-design method is safer than topologically optimized scaffold design, and three types of rational scaffold, according to each size range, confirmed that all sizes of the talus within the anatomical dimension could be covered, which was a valid result in the total talar replacement design. Accordingly, we conclude that an implant design meeting the clinical design requirements, including patient customization, weight reduction, and mechanical stability, should be possible by applying a rational inner scaffold without performing TO design. The scaffold model weight was lower than that of the solid model, and the safety was also verified through FEA.
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      Background: Total talar replacement is normally stable and satisfactory. We studied a rational scaffold talus model for each size range created through topology optimization (TO) and comparatively evaluated a topologically optimized scaffold bone talu...

      Background: Total talar replacement is normally stable and satisfactory. We studied a rational scaffold talus model for each size range created through topology optimization (TO) and comparatively evaluated a topologically optimized scaffold bone talus model using a finite element analysis (FEA). We hypothesized that the rational scaffold would be more effective for application to the actual model than the topologically optimized scaffold. Methods: Size specification for the rational model was performed via TO and inner scaffold simplification. The load condition for worst-case selection reflected the peak point according to the ground reaction force tendency, and the load directions “plantar 10°” (P10), “dorsi 5°” (D5), and “dorsi 10°” (D10) were applied to select worst-case scenarios among the P10, D5, and D10 positions (total nine ranges) of respective size specifications. FEA was performed on each representative specification-standard model, reflecting a load of 5340 N. Among the small bone models selected as the worst-case, an arbitrary size was selected, and the validity of the standard model was evaluated. The standard model was applied to the rational structure during validity evaluation, and the TO model reflecting the internal structure derived by the TO of the arbitrary model was implemented. Result: In worst-case selection, the highest peak von Mises stress (PVMS) was calculated from the minimum D5 model (532.11 MPa). Thereafter, FEA revealed peak von Mises stress levels of 218.01 MPa and 565.35 MPa in the rational and topologically optimized models, respectively, confirming that the rational model yielded lower peak von Mises stress. The weight of the minimum model was reduced from 1106 g to 965.4 g after weight reduction through rational scaffold application. Conclusion: The rational inner-scaffold-design method is safer than topologically optimized scaffold design, and three types of rational scaffold, according to each size range, confirmed that all sizes of the talus within the anatomical dimension could be covered, which was a valid result in the total talar replacement design. Accordingly, we conclude that an implant design meeting the clinical design requirements, including patient customization, weight reduction, and mechanical stability, should be possible by applying a rational inner scaffold without performing TO design. The scaffold model weight was lower than that of the solid model, and the safety was also verified through FEA.

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      참고문헌 (Reference)

      1 하동준 ; 곽희철 ; 김전교 ; 김정한 ; 이창락 ; 김영준 ; 이정한 ; 하병호 ; 김의철, "한국인 사체에서의 정상 거골의 실측" 대한족부족관절학회 20 (20): 163-169, 2016

      2 이지용 ; 정민호 ; 이진숙 ; 최병영 ; 조병필, "한국인 목말뼈 발꿈치관절면의 유형" 대한체질인류학회 25 (25): 185-192, 2012

      3 최기원 ; 최우진 ; 이진우, "족관절 인공 관절 치환술" 대한족부족관절학회 15 (15): 132-138, 2011

      4 장진주 ; 양혜미 ; 정성욱 ; 신태진 ; 김정성 ; 이근배 ; 이건우 ; 임도형, "발목인공관절 개발을 위한 발목관절 형태 및 골강도 분포 특성" 한국정밀공학회 35 (35): 27-32, 2018

      5 한바울 ; 장영웅 ; 유의식 ; 김정성 ; 김한성 ; 임도형, "경골 내 변형률 및 응력 분포 특성 분석을 통한 새로이 개발된 재치환용 인공슬관절의 생체역학적 안정성 평가: 유한요소해석" 대한의용생체공학회 34 (34): 14-23, 2013

      6 Abdulsalam A. Al-Tamimi, "Topology Optimization to Reduce the Stress Shielding Effect for Orthopedic Applications" Elsevier BV 65 : 202-206, 2017

      7 Jin-quan He, "Three-dimensional Computer-assisted Modeling of Talus Morphology in Chinese Patients" Wiley 8 (8): 383-392, 2016

      8 Silva LM, "The basics of gait analysis" 164 : 231-, 2020

      9 V. Carbone, "TLEM 2.0 – A comprehensive musculoskeletal geometry dataset for subject-specific modeling of lower extremity" Elsevier BV 48 (48): 734-741, 2015

      10 Nandy A, "Modern methods for affordable clinical gait analysis: theories and applications in healthcare systems" Acad Press 2021

      1 하동준 ; 곽희철 ; 김전교 ; 김정한 ; 이창락 ; 김영준 ; 이정한 ; 하병호 ; 김의철, "한국인 사체에서의 정상 거골의 실측" 대한족부족관절학회 20 (20): 163-169, 2016

      2 이지용 ; 정민호 ; 이진숙 ; 최병영 ; 조병필, "한국인 목말뼈 발꿈치관절면의 유형" 대한체질인류학회 25 (25): 185-192, 2012

      3 최기원 ; 최우진 ; 이진우, "족관절 인공 관절 치환술" 대한족부족관절학회 15 (15): 132-138, 2011

      4 장진주 ; 양혜미 ; 정성욱 ; 신태진 ; 김정성 ; 이근배 ; 이건우 ; 임도형, "발목인공관절 개발을 위한 발목관절 형태 및 골강도 분포 특성" 한국정밀공학회 35 (35): 27-32, 2018

      5 한바울 ; 장영웅 ; 유의식 ; 김정성 ; 김한성 ; 임도형, "경골 내 변형률 및 응력 분포 특성 분석을 통한 새로이 개발된 재치환용 인공슬관절의 생체역학적 안정성 평가: 유한요소해석" 대한의용생체공학회 34 (34): 14-23, 2013

      6 Abdulsalam A. Al-Tamimi, "Topology Optimization to Reduce the Stress Shielding Effect for Orthopedic Applications" Elsevier BV 65 : 202-206, 2017

      7 Jin-quan He, "Three-dimensional Computer-assisted Modeling of Talus Morphology in Chinese Patients" Wiley 8 (8): 383-392, 2016

      8 Silva LM, "The basics of gait analysis" 164 : 231-, 2020

      9 V. Carbone, "TLEM 2.0 – A comprehensive musculoskeletal geometry dataset for subject-specific modeling of lower extremity" Elsevier BV 48 (48): 734-741, 2015

      10 Nandy A, "Modern methods for affordable clinical gait analysis: theories and applications in healthcare systems" Acad Press 2021

      11 Han Q, "Measurement of talar morphology in northeast Chinese population based on three-dimensional computed tomography" 98 : 17142-, 2019

      12 Vidosic JP, "Machine design projects" Ronald Press 1957

      13 Kim BC, "Long term follow-up of avascular necrosis after talar fracture and dislocation: 5 cases" 9 : 31-37, 2005

      14 International Organization for Standardization, "ISO 7206-6 Implant for surgery - Partial and total hip joint prostheses - Part 6: Endurance properties testing and performance requirements of neck region of stemmed femoral components"

      15 Duo Wai-Chi Wong, "Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture" Public Library of Science (PLoS) 11 (11): e0154435-, 2016

      16 Markus Regauer, "Development of an internally braced prosthesis for total talus replacement" Baishideng Publishing Group Inc. 8 (8): 221-, 2017

      17 Benjamin W. Stevens, "Custom Talar Prosthesis After Open Talar Extrusion in a Pediatric Patient" SAGE Publications 28 (28): 933-938, 2007

      18 Joseph Tracey, "Custom 3D-Printed Total Talar Prostheses Restore Normal Joint Anatomy Throughout the Hindfoot" SAGE Publications 12 (12): 39-48, 2018

      19 Sang Soo Eun, "Compatibility of the HINTEGRA prostheses with Korean ankles as evaluated on the basis of cadaveric measurements" Wiley 25 (25): 1087-1092, 2012

      20 Robert S Adelaar, "Avascular necrosis of the talus" Elsevier BV 35 (35): 383-395, 2004

      21 Michael Damsgaard, "Analysis of musculoskeletal systems in the AnyBody Modeling System" Elsevier BV 14 (14): 1100-1111, 2006

      22 Ahearne E, "An assessment of medical grade cobalt chromium alloy ASTM F1537 as a “Difficult-to- cut (DTC)” material" 2015

      23 A. Alamdari, "A Review of Computational Musculoskeletal Analysis of Human Lower Extremities" Elsevier 37-73, 2017

      24 Rishin J, "3D printed total talus replacement for avascular necrosis of the talus" 41 : 1-8, 2020

      25 Rishin J. Kadakia, "3D Printed Total Talus Replacement for Avascular Necrosis of the Talus" SAGE Publications 41 (41): 1529-1536, 2020

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