Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not addres...

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Autores principales:	Nataliya Perevoshchikova, Kevin M. Moerman, Bardiya Akhbari, Randy Bindra, Jayishni N. Maharaj, David G. Lloyd, Maria Gomez Cerezo, Amelia Carr, Cedryck Vaquette, David J. Saxby
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/003ea5e40b4345d4b7b944bc3bca6791
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spelling	oai:doaj.org-article:003ea5e40b4345d4b7b944bc3bca67912021-11-25T06:19:28ZFinite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction1932-6203https://doaj.org/article/003ea5e40b4345d4b7b944bc3bca67912021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604338/?tool=EBIhttps://doaj.org/toc/1932-6203Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not address regeneration of the ruptured ligament, and may result in wrist functional limitations and osteoarthritis. Recently a novel multiphasic bone-ligament-bone scaffold was proposed, which aims to reconstruct the ruptured ligament, and which can be 3D-printed using medical-grade polycaprolactone. This scaffold is composed of a central ligament-scaffold section and features a bone attachment terminal at either end. Since the ligament-scaffold is the primary load bearing structure during physiological wrist motion, its geometry, mechanical properties, and the surgical placement of the scaffold are critical for performance optimisation. This study presents a patient-specific computational biomechanical evaluation of the effect of scaffold length, and positioning of the bone attachment sites. Through segmentation and image processing of medical image data for natural wrist motion, detailed 3D geometries as well as patient-specific physiological wrist motion could be derived. This data formed the input for detailed finite element analysis, enabling computational of scaffold stress and strain distributions, which are key predictors of scaffold structural integrity. The computational analysis demonstrated that longer scaffolds present reduced peak scaffold stresses and a more homogeneous stress state compared to shorter scaffolds. Furthermore, it was found that scaffolds attached at proximal sites experience lower stresses than those attached at distal sites. However, scaffold length, rather than bone terminal location, most strongly influences peak stress. For each scaffold terminal placement configuration, a basic metric was computed indicative of bone fracture risk. This metric was the minimum distance from the bone surface to the internal scaffold bone terminal. Analysis of this minimum bone thickness data confirmed further optimisation of terminal locations is warranted.Nataliya PerevoshchikovaKevin M. MoermanBardiya AkhbariRandy BindraJayishni N. MaharajDavid G. LloydMaria Gomez CerezoAmelia CarrCedryck VaquetteDavid J. SaxbyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nataliya Perevoshchikova Kevin M. Moerman Bardiya Akhbari Randy Bindra Jayishni N. Maharaj David G. Lloyd Maria Gomez Cerezo Amelia Carr Cedryck Vaquette David J. Saxby Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
description	Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not address regeneration of the ruptured ligament, and may result in wrist functional limitations and osteoarthritis. Recently a novel multiphasic bone-ligament-bone scaffold was proposed, which aims to reconstruct the ruptured ligament, and which can be 3D-printed using medical-grade polycaprolactone. This scaffold is composed of a central ligament-scaffold section and features a bone attachment terminal at either end. Since the ligament-scaffold is the primary load bearing structure during physiological wrist motion, its geometry, mechanical properties, and the surgical placement of the scaffold are critical for performance optimisation. This study presents a patient-specific computational biomechanical evaluation of the effect of scaffold length, and positioning of the bone attachment sites. Through segmentation and image processing of medical image data for natural wrist motion, detailed 3D geometries as well as patient-specific physiological wrist motion could be derived. This data formed the input for detailed finite element analysis, enabling computational of scaffold stress and strain distributions, which are key predictors of scaffold structural integrity. The computational analysis demonstrated that longer scaffolds present reduced peak scaffold stresses and a more homogeneous stress state compared to shorter scaffolds. Furthermore, it was found that scaffolds attached at proximal sites experience lower stresses than those attached at distal sites. However, scaffold length, rather than bone terminal location, most strongly influences peak stress. For each scaffold terminal placement configuration, a basic metric was computed indicative of bone fracture risk. This metric was the minimum distance from the bone surface to the internal scaffold bone terminal. Analysis of this minimum bone thickness data confirmed further optimisation of terminal locations is warranted.
format	article
author	Nataliya Perevoshchikova Kevin M. Moerman Bardiya Akhbari Randy Bindra Jayishni N. Maharaj David G. Lloyd Maria Gomez Cerezo Amelia Carr Cedryck Vaquette David J. Saxby
author_facet	Nataliya Perevoshchikova Kevin M. Moerman Bardiya Akhbari Randy Bindra Jayishni N. Maharaj David G. Lloyd Maria Gomez Cerezo Amelia Carr Cedryck Vaquette David J. Saxby
author_sort	Nataliya Perevoshchikova
title	Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
title_short	Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
title_full	Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
title_fullStr	Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
title_full_unstemmed	Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
title_sort	finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/003ea5e40b4345d4b7b944bc3bca6791
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Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

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