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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bernardo.innocenti@ulb.ac.be

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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