用于踝关节融合的3d打印胫距跟骨钉的生物力学设计考虑。

IF 3.2 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Kin Weng Wong, Shao-Fu Huang, Skye Hsin-Hsien Yeh, Tai-Hua Yang, Cheng-Yi Liang, Chun-Li Lin
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引用次数: 0

摘要

由于骨整合和机械稳定性不足,使用髓内钉治疗胫距跟骨(TTC)关节融合术面临重大挑战。本研究开发了一种新型的3d打印长钛TTC髓内钉,该钉结合了金刚石晶格结构和差动螺纹引线,以增强生物固定和压缩。设计并制造了实心(TTC 1)、点阵结构(TTC 2)、带纵筋点阵(TTC 3)、纵筋和横筋点阵(TTC 4)的4种3d打印TTC钉(直径5mm,长度70 mm)。该晶格区域具有金刚石阵列(70%孔隙率,650 μm孔径,1.2 mm单位长度),2.5 mm厚度围绕2.5 mm固体核心。静态四点弯曲试验按照ASTM F1264协议评估机械强度。6头骨骼成熟的约克郡猪采用TTC 1、2和4设计进行TTC关节融合术。术后12周通过x线影像学和显微ct分析评估结果。所有3d打印钉子都具有可接受的精度,直线度,圆度和节距误差低于5%。力学测试结果表明,TTC 1-4的断裂强度分别为2387.33±32.88 N、435.00±50.00 N、849.17±63.98 N和1133.67±81.28 N。差异螺纹设计在融合部位获得了显著的压缩比(81-82.5%)。显微ct分析显示,点阵设计(ttc2: 145.37±37.35 mm³,ttc4: 137.81±9.52 mm³)的骨形成明显高于实心设计(ttc1: 28.085±3.21 mm³)。然而,ttc2发生了两次假体骨折,而ttc4在促进骨生长的同时保持了结构完整性。本研究认为钛3D打印技术可以用于制造表面点阵设计的TTC长髓内钉,但需要增加加强筋以提供足够的机械强度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Biomechanical design considerations of a 3D-printed tibiotalocalcaneal nail for ankle joint fusion.

Tibiotalocalcaneal (TTC) arthrodesis treatment using intramedullary nails faces significant challenges due to inadequate bone integration and mechanical stability. This study developed a novel 3D-printed long titanium TTC intramedullary nail incorporating diamond lattice structures and differential thread leads to enhance biological fixation and compression. Four 3D-printed TTC nails (5 mm diameter, 70 mm length) with solid (TTC 1), lattice structure (TTC 2), lattice with longitudinal ribs (TTC 3), and lattice with both longitudinal and transverse ribs (TTC 4) were designed and manufactured. The lattice region featured a diamond array (70% porosity, 650 μm pore size, 1.2 mm unit length) with 2.5 mm thickness surrounding a 2.5 mm solid core. Static four-point bending tests assessed mechanical strength following ASTM F1264 protocols. Six skeletally mature Yorkshire pigs underwent TTC arthrodesis using TTC 1, 2, and 4 designs. Outcomes were evaluated using radiographic imaging and micro-CT analysis at 12 weeks post-surgery. All 3D-printed nails demonstrated acceptable precision with errors below 5% for straightness, circularity, and pitch distance. Mechanical testing revealed fracture strengths of 2387.33 ± 32.88 N, 435.00 ± 50.00 N, 849.17 ± 63.98 N, and 1133.67 ± 81.28 N for TTC 1-4, respectively. The differential thread design achieved significant compression ratios (81-82.5%) at fusion sites. Micro-CT analysis showed significantly higher bone formation in lattice designs (TTC 2: 145.37 ± 37.35 mm³, TTC 4: 137.81 ± 9.52 mm³) compared to the solid design (TTC 1: 28.085 ± 3.21 mm³). However, TTC 2 experienced two implant fractures, while TTC 4 maintained structural integrity while promoting substantial bone growth. This study concluded that titanium 3D printing technology can be applied for manufacturing long TTC intramedullary nails with surface lattice design but reinforcing ribs need to be added to provide enough mechanical strength.

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