Advantages of digital twin technology in orthopedic trauma Surgery - Exploring different clinical use cases.

Digital twin technology offers significant benefits for addressing fracture non-unions in orthopedic trauma surgery, particularly in cases requiring revision surgery. In this study, we developed a clinically applicable digital twin workflow that integrates patient-specific imaging, motion capture, musculoskeletal modeling, and finite element simulation. We applied this workflow to five real patient cases involving different anatomical sites and treatment strategies, including implant modification, augmentative fixation, and corrective osteotomy.

Simulation of a Custom-Made Temporomandibular Joint-An Academic View on an Industrial Workflow.

Temporomandibular joint replacement is a critical intervention for severe temporomandibular joint disorders, enhancing pain levels, jaw function and overall quality of life. In this study, we compare two finite element method-based simulation workflows from both academic and industrial perspectives, focusing on a patient-specific case involving a custom-made temporomandibular joint prosthesis. Using computed tomography data and computer-aided design data, we generated different 3D models and performed mechanical testing, including wear and static compression tests.

Individual postoperative and preoperative workflow for patients with fractures of the lower extremities.

Background: The individual assessment of the postoperative healing situation contributes significantly to detecting healing disorders, ensuring the mechanical stability of implants, and planning revision surgeries.

Methods: Our established workflow consists of the following steps: (1) Monitoring of the patients during their treatment course with a motion capturing system as kinematic and sensor insoles for the kinetic gait analysis, (2) transfer of the motion data into the musculoskeletal simulation system AnyBody™ to achieve the corresponding individual muscle and joint forces. (3) Clinical imaging of the patients via postoperative computed tomography scans, ideally combined with a six-rod bone density calibration phantom.

Finite element simulations of smart fracture plates capable of cyclic shortening and lengthening: which stroke for which fracture?

Bone healing can be improved by axial micromovement, as has been shown in animals and human patients with external fixators. In the development of smart fracture plates, the ideal amount of stroke for different fracture types in the different healing stages is currently unknown. It was hypothesized that the resulting strain in the fracture gap of a simple tibial shaft fracture does not vary with the amount of axial stroke in the plate, the fracture gap size, and the fracture angle.

Experimental and virtual testing of bone-implant systems equipped with the AO Fracture Monitor with regard to interfragmentary movement.

The management of fractured bones is a key domain within orthopedic trauma surgery, with the prevention of delayed healing and non-unions forming a core challenge. This study evaluates the efficacy of the AO Fracture Monitor in conjunction with biomechanical simulations to better understand the local mechanics of fracture gaps, which is crucial for comprehending mechanotransduction, a key factor in bone healing. Through a series of experiments and corresponding simulations, the study tests four hypotheses to determine the relationship between physical measurements and the predictive power of biomechanical models.

Simulation-based prediction of bone healing and treatment recommendations for lower leg fractures: Effects of motion, weight-bearing and fibular mechanics.

Despite recent experimental and clinical progress in the treatment of tibial and fibular fractures, in clinical practice rates of delayed bone healing and non-union remain high. The aim of this study was to simulate and compare different mechanical conditions after lower leg fractures to assess the effects of postoperative motion, weight-bearing restrictions and fibular mechanics on the strain distribution and the clinical course. Based on the computed tomography (CT) data set of a real clinical case with a distal diaphyseal tibial fracture, a proximal and a distal fibular fracture, finite element simulations were run.

Concepts and clinical aspects of active implants for the treatment of bone fractures.

Nonunion is a complication of long bone fractures that leads to disability, morbidity and high costs. Early detection is difficult and treatment through external stimulation and revision surgery is often a lengthy process. Therefore, alternative diagnostic and therapeutic options are currently being explored, including the use of external and internal sensors.

Individualized Determination of the Mechanical Fracture Environment After Tibial Exchange Nailing-A Simulation-Based Feasibility Study.

Non-union rate after tibial fractures remains high. Apart from largely uncontrollable biologic, injury, and patient-specific factors, the mechanical fracture environment is a key determinant of healing. Our aim was to establish a patient-specific simulation workflow to determine the mechanical fracture environment and allow for an estimation of its healing potential.