AccScience Publishing / IJB / Volume 10 / Issue 1 / DOI: 10.36922/ijb.1584
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Designing a 3D-printed medical implant with mechanically macrostructural topology and microbionic lattices: A novel wedge-shaped spacer for high tibial osteotomy and biomechanical study

Hsuan-Wen Wang1,2† Chih-Hwa Chen3,4,5,6† Kuan-Hao Chen4,7 Yu-Hui Zeng1 Chun-Li Lin1,2*
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1 Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
2 Medical Device Innovation & Translation Center, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
3 School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
4 Department of Orthopedics, Taipei Medical University–Shuang Ho Hospital, New Taipei City, Taiwan
5 School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
6 Research Center of Biomedical Device, Taipei Medical University, Taipei, Taiwan
7 Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medial University, Taipei, Taiwan
IJB 2024, 10(1), 1584
Submitted: 11 August 2023 | Accepted: 13 October 2023 | Published: 10 January 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

Metal three-dimensional (3D) printing has become an important manufacturing process in medical implant development. Nevertheless, the metal 3D-printed implant needs to be considered with structural optimization to reduce the stress-shielding effects and to be incorporated with a lattice design to generate better bone ingrowth environment. This study combines topology optimization (TO) and lattice design to acquire an optimal wedge-shaped spacer (OWS) for high tibial osteotomy (HTO) fixation. The OWS was manufactured using titanium alloy 3D printing to conduct biomechanical fatigue testing for mechanical performance validation. A solid wedge-shaped spacer (SWS) with three embedded screws was designed using the HTO model. An OWS was obtained under physiological loads through finite element (FE) analysis and TO. A deformed YM lattice with a porosity of 60% and pore size of 700 μm was filled at the OWS posterior region. The HTO mechanical performance was simulated for SWS, OWS, and commercial T-shaped plate (TP) fixations using FE analysis. The displacement/fracture patterns under OWS and TP fixations were verified using fatigue testing. The manufacturing errors for all 3D-printed OWS features were found to be less than 1%. The FE results revealed that the OWS fixation demonstrated reductions of 56.46%, 11.98%, and 64.31% in displacement, stress in the implant and bone, respectively, compared to the TP fixation. The fatigue test indicated that the OWS fixation exhibited smaller displacement for the HTO, as well as a higher load capacity, minor bone fracture collapse, and a greater number of cycles than the TP system. This study concluded that medical implants can be designed by integrating macro TO and microlattice design to provide enough mechanical strength and an environment for bone ingrowth after surgery. Both FE analysis and biomechanical fatigue tests confirmed that OWS mechanical performance with lattice design was more stable than the HTO TP fixations.

3D printing
Topology optimization
Finite element
High tibial osteotomy
This study was supported in part by NSTC project 112-2221-E-A49-009-MY3 and 111-2327-B-A49-006, Taiwan.
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Conflict of interest
The authors declare no conflicts of interest.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing