TY - JOUR A1 - Schmitz, Paul A1 - Neumann, Christoph Cornelius A1 - Neumann, Carsten A1 - Nerlich, Michael A1 - Dendorfer, Sebastian T1 - Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting JF - Journal of Orthopaedic Surgery and Research N2 - Background Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Methods Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Results Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. Conclusion A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture. KW - Bone harvesting KW - Autologous bone graft KW - Iliac crest KW - Fatigue fracture KW - Pelvis KW - ASIS KW - FEA KW - Biomechanical investigation KW - Beckenkammknochen KW - Knochenentnahme KW - Spongiosa KW - Biomechanische Analyse Y1 - 2018 U6 - https://doi.org/10.1186/s13018-018-0822-1 VL - 13 IS - 108 SP - 1 EP - 8 PB - Springer Nature ER - TY - CHAP A1 - Jungtäubl, Dominik A1 - Schmitz, Paul A1 - Gross, Simon A1 - Dendorfer, Sebastian ED - Badnjevic, Almir T1 - FEA of the transiliacal internal fixator as an osteosynthesis of pelvic ring fractures T2 - CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017 N2 - Common Schanz screw systems can be used to stabilize pelvic ring fractures. In order to accommodate for different patient’s requirements, implants can be placed in cranio-caudal direction into the os ilium (T1), or into the supraacetabular bone canal, and thus, in dorso-ventral direction (T2). Whereas both techniques are currently used, no data of the biomechanical behavior is available up to this date. The aim of this study is to analyze, whether T2 shows biomechanical advantages with respect to tissue and implant stresses due to the enlarged bone-implant interface. Forces acting on the pelvis were analyzed using motion capture data of a gait cycle obtained by the utilization of a musculoskeletal simulation program. A three dimensional finite element (FE) model of the pelvis with grayscale-based material properties was generated. The muscle and joint reaction forces at toe-off were applied to the FE model and instable pelvis fractures were implemented. The osteosynthesis systems were positioned within the model in order to enable the comparison between the two different surgical techniques. Stresses and displacements were analyzed for bone tissue, fracture zone and implant. T2 lead to approx. 30% larger displacements in the fracture zone. Von-Mises stresses were larger for T2 in the implant (80 MPa vs. 227 MPa), whereas T1 leads to larger stresses in the bone tissue (200 MPa vs. 140 MPa). Both implantation techniques showed a good biomechanical behavior. Differences could be found with respect to tissue strains and deformations in the fracture zone. If bone quality or fracture healing are of concern, T2 or T1 should be used, respectively. However, both techniques seem to be applicable for cases with no special requirements. Further analyses aim to investigate the behavior under cyclic loading. KW - Finite element analysis KW - Musculoskeletal simulation KW - Internal fixator KW - Pelvic ring fracture KW - Beckenbruch KW - Operationstechnik KW - Finite-Elemente-Methode KW - Biomechanik KW - Simulation Y1 - 2017 SN - 978-981-10-4165-5 U6 - https://doi.org/10.1007/978-981-10-4166-2_32 SP - 212 EP - 217 PB - Springer CY - Singapore ER -