Patient-specific implants in trauma surgery
Patient-specific implants in trauma surgery
This dissertation of Miriam Oldhoff investigated the application of patient-specific implants (PSIs) in trauma surgery. Conventional, standardized implants do not always fit well with the anatomical variation among patients, especially in complex fractures. Because of 3D technology, implants can now be custom-designed, enabling accurate reconstruction and improved screw placement. Part of the dissertation combined biomechanical analyses, such as Finite Element Analysis (FEA), with physical testing to evaluate the performance of PSIs. In addition, cadaver studies were conducted to assess the feasibility of PSIs. The dissertation focused on three types of PSI applications: for acetabular fractures, tibial plateau fractures, and corrective osteotomies.
The first part focused on acetabular fractures. FEA demonstrated that PSIs result in lower bone stresses and a reduced risk of implant failure compared to conventional implants. Mechanical testing using synthetic bone confirmed comparable stiffness and strength over time between both implant types, establishing a reproducible biomechanical testing workflow.
The second part investigated PSIs for tibial plateau fractures. A study involving cadaveric knees showed that PSIs, designed through virtual 3D planning, enable accurate reduction and screw placement. An additional biomechanical testing protocol was developed to further evaluate the load-bearing capacity of PSIs.
The third part addressed PSIs for corrective osteotomies. For both the distal radius and the long bones of the lower extremities, PSIs proved to be feasible and potentially valuable.
This dissertation represents an important step toward the clinical implementation of PSIs, providing studies that demonstrates how patient-specific implants can enhance surgical precision and expand treatment options in trauma surgery.