Three-dimensional finite element model construction and biomechanical analysis of customized titanium alloy lunate prosthesis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Bin ¹ , CAI Xingbo ^1,2 , ZHANG Yue ¹ , ZHANG Bihuan ¹ ,  XU Yongqing ²

1. Graduate School of Kunming Medical University, Kunming Yunnan, 650000, P. R. China;
2. Department of Orthopedics, the 920th Hospital of Joint Logistics Support Force of Chinese PLA, Kunming Yunnan, 650000, P. R. China;

Corresponding?author：

XU Yongqing, Email: xuyongqingkm@163.net

Keywords：

Kienb?ck disease; customized prosthesis; lunate replacement; finite element analysis; biomechanics

DOI：

10.7507/1002-1892.202301039

Video：

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Objective To design customized titanium alloy lunate prosthesis, construct three-dimensional finite element model of wrist joint before and after replacement by finite element analysis, and observe the biomechanical changes of wrist joint after replacement, providing biomechanical basis for clinical application of prosthesis. Methods One fresh frozen human forearm was collected, and the maximum range of motions in flexion, extension, ulnar deviation, and radialis deviation tested by cortex motion capture system were 48.42°, 38.04°, 35.68°, and 26.41°, respectively. The wrist joint data was obtained by CT scan and imported into Mimics21.0 software and Magics21.0 software to construct a wrist joint three-dimensional model and design customized titanium alloy lunate prosthesis. Then Geomagic Studio 2017 software and Solidworks 2017 software were used to construct the three-dimensional finite element models of a normal wrist joint (normal model) and a wrist joint with lunate prosthesis after replacement (replacement model). The stress distribution and deformation of the wrist joint before and after replacement were analyzed for flexion at and 15°, 30°, 48.42°, extension at 15°, 30°, and 38.04°, ulnar deviation at 10°, 20°, and 35.68°, and radial deviation at 5°, 15°, and 26.41° by the ANSYS 17.0 finite element analysis software. And the stress distribution of lunate bone and lunate prosthesis were also observed. Results The three-dimensional finite element models of wrist joint before and after replacement were successfully constructed. At different range of motion of flexion, extension, ulnar deviation, and radial deviation, there were some differences in the number of nodes and units in the grid models. In the four directions of flexion, extension, ulnar deviation, and radial deviation, the maximum deformation of wrist joint in normal model and replacement model occurred in the radial side, and the values increased gradually with the increase of the range of motion. The maximum stress of the wrist joint increased gradually with the increase of the range of motion, and at maximum range of motion, the stress was concentrated on the proximal radius, showing an overall trend of moving from the radial wrist to the proximal radius. The maximum stress of normal lunate bone increased gradually with the increase of range of motion in different directions, and the stress position also changed. The maximum stress of lunate prosthesis was concentrated on the ulnar side of the prosthesis, which increased gradually with the increase of the range of motion in flexion, and decreased gradually with the increase of the range of motion in extension, ulnar deviation, and radialis deviation. The stress on prosthesis increased significantly when compared with that on normal lunate bone. Conclusion The customized titanium alloy lunate prosthesis does not change the wrist joint load transfer mode, which provided data support for the clinical application of the prosthesis.

Citation： WANG Bin, CAI Xingbo, ZHANG Yue, ZHANG Bihuan, XU Yongqing. Three-dimensional finite element model construction and biomechanical analysis of customized titanium alloy lunate prosthesis. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 821-826. doi: 10.7507/1002-1892.202301039 Copy

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2.	趙萬秋, 徐永清. 月骨的臨床解剖學及人工假體的研究進展. 生物骨科材料與臨床研究, 2020, 17(6): 60-64.
3.	Kanatani T, Yamasaki K, Fujioka H. Carpal tunnel syndrome associated with a fracture of a silicone implant for Kienb?ck’s disease: two case reports. Hand Surg, 2010, 15(3): 225-227.
4.	Viljakka T, Tallroth K, Vastam?ki M. Long-term outcome (22-36 years) of silicone lunate arthroplasty for Kienbock’s disease. J Hand Surg (Eur Vol), 2014, 39(4): 405-415.
5.	李睿夫, 繆旭東, 閆喬生, 等. 骨水泥假體置換治療月骨缺血性壞死的臨床研究. 中國現代醫學雜志, 2017, 27(1): 107-110.
6.	徐永清, 宋慕國, 范新宇, 等. 3D打印微孔鈦人工腕關節的設計與臨床應用. 中華關節外科雜志 (電子版), 2021, 15(2): 143-150.
7.	馬天曉. 3D打印多孔結構軟組織長入的組織學特性. 石家莊: 河北醫科大學, 2020.
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9.	Brown CP, Nguyen TC, Moody HR, et al. Assessment of common hyperelastic constitutive equations for describing normal and osteoarthritic articular cartilage. Proc Inst Mech Eng H, 2009, 223(6): 643-652.
10.	Bajuri MN, Abdul Kadir MR, Murali MR, et al. Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis. Med Biol Eng Comput, 2013, 51(1-2): 175-186.
11.	Gíslason MK, Stansfield B, Nash DH. Finite element model creation and stability considerations of complex biological articulation: The human wrist joint. Med Eng Phys, 2010, 32(5): 523-531.
12.	張浩, 朱建民, 馬南, 等. 腕關節有限元骨性建模及力學分析. 江蘇大學學報 (醫學版), 2013, 23(1): 53-56.
13.	魏明杰, 許育健, 吳一芃, 等. 手腕部不同載荷狀態下舟月骨間韌帶應力分布分析. 中國臨床解剖學雜志, 2021, 39(5): 586-592.
14.	Gholamian F, Ashrafi M, Moradi A. Finite element analysis of intraosseous distal radioulnar joint prosthesis. BMC Musculoskelet Disord, 2022, 23(1): 785. doi: 10.1186/s12891-022-05746-3.
15.	Bajuri MN, Kadir MR, Raman MM, et al. Mechanical and functional assessment of the wrist affected by rheumatoid arthritis: A finite element analysis. Med Eng Phys, 2012, 34(9): 1294-1302.
16.	Gislason MK, Foster E, Bransby-Zachary M, et al. Biomechanical analysis of the Universal 2 implant in total wrist arthroplasty: a finite element study. Comput Methods Biomech Biomed Engin, 2017, 20(10): 1113-1121.
17.	Manal K, Lu X, Nieuwenhuis MK, et al. Force transmission through the juvenile idiopathic arthritic wrist: a novel approach using a sliding rigid body spring model. J Biomech, 2002, 35(1): 125-133.
18.	Horii E, Garcia-Elias M, Bishop AT, et al. Effect on force transmission across the carpus in procedures used to treat Kienb?ck’s disease. J Hand Surg (Am), 1990, 15(3): 393-400.
19.	Iwasaki N, Genda E, Minami A, et al. Force transmission through the wrist joint in Kienb?ck's disease: a two-dimensional theoretical study. J Hand Surg (Am), 1998, 23(3): 415-424.
20.	Schuind F, Cooney WP, Linscheid RL, et al. Force and pressure transmission through the normal wrist. A theoretical two-dimensional study in the posteroanterior plane. J Biomech, 1995, 28(5): 587-601.
21.	Genda E, Horii E. Theoretical stress analysis in wrist joint-neutral position and functional position. J Hand Surg (Br), 2000, 25(3): 292-295.

1. Lesley N, Lichtman D. Classification and treatment of Kienbock disease: a review of the past 100 years, and a look at the future. Handchir Mikrochir Plast Chir, 2010, 42(3): 171-176.
2. 趙萬秋, 徐永清. 月骨的臨床解剖學及人工假體的研究進展. 生物骨科材料與臨床研究, 2020, 17(6): 60-64.
3. Kanatani T, Yamasaki K, Fujioka H. Carpal tunnel syndrome associated with a fracture of a silicone implant for Kienb?ck’s disease: two case reports. Hand Surg, 2010, 15(3): 225-227.
4. Viljakka T, Tallroth K, Vastam?ki M. Long-term outcome (22-36 years) of silicone lunate arthroplasty for Kienbock’s disease. J Hand Surg (Eur Vol), 2014, 39(4): 405-415.
5. 李睿夫, 繆旭東, 閆喬生, 等. 骨水泥假體置換治療月骨缺血性壞死的臨床研究. 中國現代醫學雜志, 2017, 27(1): 107-110.
6. 徐永清, 宋慕國, 范新宇, 等. 3D打印微孔鈦人工腕關節的設計與臨床應用. 中華關節外科雜志 (電子版), 2021, 15(2): 143-150.
7. 馬天曉. 3D打印多孔結構軟組織長入的組織學特性. 石家莊: 河北醫科大學, 2020.
8. Krone R, Schuster P. An investigation on the importance of material anisotropy in finite-element modeling of the human femur[C/OL]. [2023-06-08]. https://doi.org/10.4271/2006-01-0064.
9. Brown CP, Nguyen TC, Moody HR, et al. Assessment of common hyperelastic constitutive equations for describing normal and osteoarthritic articular cartilage. Proc Inst Mech Eng H, 2009, 223(6): 643-652.
10. Bajuri MN, Abdul Kadir MR, Murali MR, et al. Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis. Med Biol Eng Comput, 2013, 51(1-2): 175-186.
11. Gíslason MK, Stansfield B, Nash DH. Finite element model creation and stability considerations of complex biological articulation: The human wrist joint. Med Eng Phys, 2010, 32(5): 523-531.
12. 張浩, 朱建民, 馬南, 等. 腕關節有限元骨性建模及力學分析. 江蘇大學學報 (醫學版), 2013, 23(1): 53-56.
13. 魏明杰, 許育健, 吳一芃, 等. 手腕部不同載荷狀態下舟月骨間韌帶應力分布分析. 中國臨床解剖學雜志, 2021, 39(5): 586-592.
14. Gholamian F, Ashrafi M, Moradi A. Finite element analysis of intraosseous distal radioulnar joint prosthesis. BMC Musculoskelet Disord, 2022, 23(1): 785. doi: 10.1186/s12891-022-05746-3.
15. Bajuri MN, Kadir MR, Raman MM, et al. Mechanical and functional assessment of the wrist affected by rheumatoid arthritis: A finite element analysis. Med Eng Phys, 2012, 34(9): 1294-1302.
16. Gislason MK, Foster E, Bransby-Zachary M, et al. Biomechanical analysis of the Universal 2 implant in total wrist arthroplasty: a finite element study. Comput Methods Biomech Biomed Engin, 2017, 20(10): 1113-1121.
17. Manal K, Lu X, Nieuwenhuis MK, et al. Force transmission through the juvenile idiopathic arthritic wrist: a novel approach using a sliding rigid body spring model. J Biomech, 2002, 35(1): 125-133.
18. Horii E, Garcia-Elias M, Bishop AT, et al. Effect on force transmission across the carpus in procedures used to treat Kienb?ck’s disease. J Hand Surg (Am), 1990, 15(3): 393-400.
19. Iwasaki N, Genda E, Minami A, et al. Force transmission through the wrist joint in Kienb?ck's disease: a two-dimensional theoretical study. J Hand Surg (Am), 1998, 23(3): 415-424.
20. Schuind F, Cooney WP, Linscheid RL, et al. Force and pressure transmission through the normal wrist. A theoretical two-dimensional study in the posteroanterior plane. J Biomech, 1995, 28(5): 587-601.
21. Genda E, Horii E. Theoretical stress analysis in wrist joint-neutral position and functional position. J Hand Surg (Br), 2000, 25(3): 292-295.

Chinese Journal of Reparative and Reconstructive Surgery

Three-dimensional finite element model construction and biomechanical analysis of customized titanium alloy lunate prosthesis

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