A new algorithm for finite element simulation of wedge osteotomies in voxel models with application to the tibia

Thomas Pressel¹, Markus D Schofer¹, Jörg Meiforth², Markus Lengsfeld¹, Jan Schmitt¹

¹Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany; ²St. Vincentius Kliniken, Klinik für Orthopädie, Karlsruhe, Germany

Abstract: Wedge osteotomies are used to correct bone deformities or change the forces acting on bones and joints in the human body. Finite element models can be employed to simulate the effect of such operations on the bone or adjacent joints. The automatic generation of voxel models derived from computed tomography data is a common procedure, but the major drawback of the method lies in irregular model surfaces. Therefore, the concept of hybrid models combining voxel and tetrahedron meshes was developed. We present an algorithm to simulate wedge osteotomies in voxel models by adding tetrahedron to brick elements. Applicability of the procedure was tested by performing a parametric study using a tibia model created from computed tomography scans taken in vivo applying individually calculated force conditions. The osteotomy angle largely affected maximum stresses: at 2.5 degrees valgus, the stresses at the medial and lateral tibial plateau were equivalent, while increasing valgus angles reduced medial stresses. The algorithm described here is an improvement of former mesh generation procedures and allows a better representation of the geometry at the osteotomy level. The algorithm can be used for all wedge osteotomies and is not limited to the tibia.

Keywords: finite element/osteotomy/voxel/pre-operative planning, simulation, mesh algorithm