2013 03-12-masterclass-biomedical-applications-of-am ulb-add-medical
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Transcript of 2013 03-12-masterclass-biomedical-applications-of-am ulb-add-medical
Part 01: General considerations and clinical case studies
Biomedical applications of Additive Manufacturing
Masterclass:
Taking into consideration the biomechanical aspects:
anatomy and functional aspects of the body.
Prof. Bernardo Innocenti, PhD
BEAMS Department (Bio Electro and Mechanical Systems) Ecole Polytechnique Université Libre de Bruxelles Av. F. Roosevelt, 50 CP165/56 1050 Bruxelles
Biomedical applications of Additive Manufacturing
Masterclass:
The Speaker
Why Anatomy and Function
How we can determine Anatomy
How we can measure Function
What happen if Anatomy or Function changes
Take Home Message
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Master Degree in Mechanical Engineering, Department of Mechanical and Industrial Technology, University of Florence;
PhD in Mechanical Design, Department of Mechanical and Industrial Technology, University of Florence
September 2003 - April 2007: Contract Professor, University of Florence
January 2006 – April 2007: PostDoc, Responsible of BioLAB
May 2007 – September 2012:Lead Project Manager Numerical Kinematics European Center for Knee Research, Smith & Nephew Haasrode, Leuven, Belgium
2011 – Present: Guest Professor, Division of Biomechanics, Department of Mechanical Engineering, KU Leuven
October 2012 - Present: Professor of Biomechanics Université Libre de Bruxelles
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Orthopaedic Biomechanics
Numerical modeling
Knee biomechanics
Patient specific modeling
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Muybridge, ~1880
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Patient profile is changing!! Age Activity Higher
expectation
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Frame
Upper leg (femur - Two dof) • vertical movement • rotation around ML axis
Lower leg (Tibia - Five dof)
• three rotations • two translations
Two actuators
• One exerting a load on the hip (vertical sliding) • One pulling the quadriceps
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Extensometer TekScan Contact Pressure Sensor
Hamstring Quadriceps
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9/12 points in the space are enough?
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Identify the Landmarks
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Medial Condylar Centre Lateral Condylar Centre
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Hip Centre
Knee Centre
FEMORAL MECHANICAL AXIS (FMA)
Insertion MCL Insertion LCL
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Frontal plane FPF Includes FMAx and is parallel to EPI Ax
Sagittal plane SPF Includes FMAx and is perpendicular to FPF
Horizontal plane HPF Includes knee ctr and is perpendicular to FPF and SPF
FMA
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Medial Condylar
Centre Lateral Condylar
Centre
Frontal plane FPT Includes TMAx and is parallel to TTAx
Sagittal plane SPT Includes TMAx and is perpendicular to FPT
Horizontal plane HPT Includes tib ctr and is perpendicular to FPT and SPT
TIBIAL MECHANICAL AXIS (TMAx)
Tibia Centre
Ankle Centre
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• 30 points pre-op CT scan • 25 points post-op CT scan • Identification protocol for each point • Bony landmark definitions from literature when possible
LaPrade AJSM LaPrade JBJS
• Control frame integrity on post-op CAT scan
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Mean
0
0.5
1
1.5
2
2.5
3
knee
ctr
tib tu
b
hip ct
r
ins M
PFL F
ankl
ctr
lcc
ins sM
CL F
ins LCL F mcp
med co
nd c
add t
ub
lat co
nd c
med co
nd p
mcc
pat a
pex
med ep
i
pat la
t
tib ct
r
lat epi
pat p
cr
ins LCL f
i
lat co
nd p
tip fib
pat d
cr lcp
gast
tub
troch
prox
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Database Kinematics and Kinetics 70 cadaveric specimen(in progress)
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Experimental Numerical
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CT scan of a full cadaver leg
Bones reconstruction
Locations of tissues insertion points
Theoretical physiological
model
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Analyzed TKA
Theoretical replaced
model
Virtual cutting of the bones according to surgical
technique
Hinge Design
Fix Bearing PS design
Fix Bearing BCS design
Mobile Bearing design
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IE rotation
± 10°
Tibial Component Patellar Component
Patella Alta/Baha configuration
BPI =0.59 - 1.29 Tibial Slope ± 3°
AP translation ± 5mm
Abb/Add ± 3°
ML translation ± 5mm
Tibial IE ± 3°
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LCL and MCL Patellar Tendon
PD translation ±5mm PD translation ±5mm;
AP translation ±5mm;
ML translation ±5mm;
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[Innocenti et al., 2009a and 2009b; Victor et al., 2009 and 2010]
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Singerman et al. (1994):
PF contact force depends on patellar height;
Luyckx et al. (2009):
PF force increases with patellar height;
Innocenti et al. (2009):
PF increases linearly with the increase of BP index.
Medial and Lateral maximum Femoro-Tibial force
00.5
11.5
22.5
33.5
4
PS Design BCS Design Hinge Design Mobile BearingDesign
BWAlta lat Theoretical lat Baha latAlta med Theoretical med Baha med
Maximum Patello-Femoral force
0
1
2
3
4
5
6
7
PS Design BCS Design Hinge Design Mobile BearingDesign
BW
Alta Theoretical Baha
Patella Alta/Baja configurations
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Questions? Organized by SIRRIS the 12th of March 2013 Masterclass: Biomedical applications of Additive Manufacturing