The effect of the degradation pattern of biodegradable bone plates on the healing process using a biphasic mechano-regulation theory.

Abstract

Bone plates are used to treat bone fractures by stabilizing the fracture site and allowing treatments to take place. Mechanical properties of the applied bone plate determine the stability of the fracture site and affect the endochondral ossification process and the healing performance. In recent years, biodegradable bone plates have been used in demand for the elimination of a second surgery to remove the plate. The degradation of these plates into the body environment is commonly accompanied by alterations in the mechanical properties of the bone plate and a shift in the healing performance of the bone. In the present study, the effects of using biodegradable plates with various elastic moduli and degradation patterns, including linear and nonlinear, on the healing process are investigated. A three-dimensional finite element model of the radius bone along with a mechano-regulation theory was used to study the healing performance. Two mechanical stimuli of octahedral shear strain and interstitial fluid flow are considered as the propelling factors of healing. The results of this study indicated that increasing the bone plate's initial elastic modulus accelerates the healing process. However, by increasing the initial Young's modulus of the plate more than 100 GPa, no noticeable alteration is observed. The degradation time period of the plate was seen to be directly related to the speed of the healing process. It is shown, however, that by increasing the degradation time period to more than 8weeks, the healing performance remains almost unchanged. The results of this work showed that the application of plates with a high enough initial elastic modulus and degradation period can prevent the healing process from decelerating.