Abstract
A tumour resection normally involves a large tissue resection and bone replacement. Polyether ether ketone (PEEK) has become a suitable candidate for use in various prostheses owing to its lightness in weight, modulus close to that of natural bone, and good biocompatibility, among other factors. This study proposes a new design method for a rib prosthesis using the centroid trajectory of the natural replaced rib, where the strength can be adjusted by monitoring the cross-sectional area, shape, and properties. A custom-designed rib prosthesis was manufactured using fused deposition modelling (FDM) manufacturing technology, and the mechanical behaviour was found to be close to that of a natural rib. A finite element analysis of the designed rib was carried out under similar loading conditions to those used in mechanical testing. The results indicate that the centroid trajectory derived from a natural rib diaphysis can provide reliable guidance for the design of a rib prosthesis. Such methodology not only offers considerable design freedom in terms of shape and required strength, but also benefits the quality of the surface finishing for samples manufactured using the FDM technique. FDM-printed PEEK rib prostheses have been successfully implanted, and good clinical performances have been achieved.Graphical abstract
Highlights
Chest wall resections are often required when dealing with malignant tumours, congenital deformities, or thoracic injuries from vehicle crashes, and may lead to the risk of a rib excision
The maximum von Mises stress of cancellous bone was over the yield strength of the material (2.2 MPa), which may lead to a high risk of fracture in the maximum stress position
The stiffness of prosthesis is larger than that of natural rib owing to the difference of elastic modulus between cortical bone and Polyether ether ketone (PEEK) materials
Summary
Chest wall resections are often required when dealing with malignant tumours, congenital deformities, or thoracic injuries from vehicle crashes, and may lead to the risk of a rib excision. The development of human rib replacement techniques has received significant attention in terms of chest wall reconstructions as a way to maintain the normal respiratory function of patients (Moradiellos et al 2017; Simal et al 2016; Wang et al 2016; Wu et al 2016). Statistical results have shown a relatively high incidence rate of post-operative complications (Weyant et al 2006), reaching up to 27% for massive chest wall defects (Berthet et al 2012). Improvements in the clinical performance of prostheses and a reduction in the incidence rate of post-operative complications through the use of better-suited biomaterials and a subject-specific design are still required
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