Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Engineering Science

Program

Biomedical Engineering

Collaborative Specialization

Musculoskeletal Health Research

Supervisor

Burkhart, Timothy

Affiliation

University of Toronto

2nd Supervisor

Willing, Ryan

Joint Supervisor

3rd Supervisor

Getgood, Alan

Co-Supervisor

Abstract

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.

Summary for Lay Audience

This thesis focuses on engineering and clinical components to improve the surgical outcome of a medial opening wedge high tibial osteotomy (MOWHTO). The aim of this thesis is to develop and validate a computation model to investigate the effect of hinge axis orientation on knee alignment while analyzing the mechanical response around the hinge in a MOWHTO. Chapter 2 highlights the importance of selecting an appropriate modeling method that best represents the clinical scenario. Chapter 3 validated a FE model that yielded acceptable limits of agreement when compared to an experimental study. 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 alignment of the knee and quantified the mechanical response between each hinge axis orientation through the anterior (structure at the front of the shin bone) and posterior (structure at the back of the shine bone) region of the hinge. This work will improve the understanding of bone in complicated loading processes, such as in the opening of a MOWHTO or in post-surgical loading, that will provide a method to model different loading scenarios for a MOWHTO study. This research will provide a comprehensive, biological method of performing virtual clinical studies that will improve the understanding of a MOWHTO and its effects of the knee. Ultimately, this work provides a validated FE model that may be used to investigate the effect a MOWHTO has on the knee alignment along with providing a better understanding of the biomechanics on the hinge post-MOWHTO.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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