Developing a Finite Element Model for Evaluating the Posterior Tibial Slope in a Medial Opening Wedge High Tibial Osteotomy

This thesis aimed to develop and validate a computation finite element (FE) model to investigate the effect of hinge axis orientation on the posterior tibial slope (PTS) and mechanical medial proximal tibial angle (mMPTA) while analyzing the mechanical response around the hinge in a medial opening wedge high tibial osteotomy (MOWHTO). Chapter 2 highlights the importance of selecting an appropriate modeling method that best represents the clinical scenario. Chapter 3 validated a FE model using the Bland-Altman agreement analysis which yielded 95% limits of agreement of −0.9° to 1.2° for PTS and −1.4° to 1.9° for mMPTA. A parametric study was presented in Chapter 4 to investigate the effect of a 15° internal and external hinge axis rotation (with respect to a neutral hinge axis orientation) on the PTS and quantified the stresses and strains between each hinge axis orientation through the anterior and posterior region of the hinge.

Keywords: High Tibial Osteotomy; MOWHTO; Finite Element Modeling; FEM; Tibial Slope; Stress Analysis; Osteotomy; Knee Osteoarthritis; Hinge Axis Orientation

Year	Entry
2007	Faul F, Erdfelder E, Lang A-G, Buchner A. GPower 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods*. May 2007;39(2):175-191.
2001	Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. July 11, 2001;286(2):188-195.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
2004	Doblaré M, García JM, Gomez MJ. Modelling bone tissue fracture and healing: a review. Eng Fract Mech. September 2004;71(13-14):1809-1840.
2008	Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. January 2008;58(1):26-35.
2013	Burkhart TA, Andrews DM, Dunning CE. Finite element modeling mesh quality, energy balance and validation methods: a review with recommendations associated with the modeling of bone tissue. J Biomech. May 31, 2013;46(9):1477-1488.
1991	Snyder SM, Schneider E. Estimation of mechanical properties of cortical bone by computed tomography. J Orthop Res. May 1991;9(3):422-431.
1992	Linde F, Hvid I, Madsen F. The effect of specimen geometry on the mechanical behaviour of trabecular bone specimens. J Biomech. 1992;25(4):359-368.
1986	Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. February 8, 1986;327(8476):307-310.
2007	Laz PJ, Stowe JQ, Baldwin MA, Petrella AJ, Rullkoetter PJ. Incorporating uncertainty in mechanical properties for finite element-based evaluation of bone mechanics. J Biomech. 2007;40(13):2831-2836.

Year

Entry

2007

Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. May 2007;39(2):175-191.

2001

Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. July 11, 2001;286(2):188-195.

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

2004

Doblaré M, García JM, Gomez MJ. Modelling bone tissue fracture and healing: a review. Eng Fract Mech. September 2004;71(13-14):1809-1840.

2008

Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. January 2008;58(1):26-35.