Enhancing the Efficiency of Distraction Osteogenesis through Rate-Varying Distraction: A Computational Study |
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Authors: | Ruisen Fu Yili Feng David Bertrand Tianming Du Youjun Liu Bettina M. Willie Haisheng Yang |
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Affiliation: | 1.Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China; (R.F.); (Y.F.); (T.D.); (Y.L.);2.Department of Pediatric Surgery, McGill University, Montreal, QC H4A 3J1, Canada; (D.B.); (B.M.W.);3.Research Centre, Shriners Hospital for Children-Canada, Montreal, QC H4A 0A9, Canada |
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Abstract: | Distraction osteogenesis (DO) is a mechanobiological process of producing new bone and overlying soft tissues through the gradual and controlled distraction of surgically separated bone segments. The process of bone regeneration during DO is largely affected by distraction parameters. In the present study, a distraction strategy with varying distraction rates (i.e., “rate-varying distraction”) is proposed, with the aim of shortening the distraction time and improving the efficiency of DO. We hypothesized that faster and better healing can be achieved with rate-varying distractions, as compared with constant-rate distractions. A computational model incorporating the viscoelastic behaviors of the callus tissues and the mechano-regulatory tissue differentiation laws was developed and validated to predict the bone regeneration process during DO. The effect of rate-varying distraction on the healing outcomes (bony bridging time and bone formation) was examined. Compared to the constant low-rate distraction, a low-to-high rate-varying distraction provided a favorable mechanical environment for angiogenesis and bone tissue differentiation, throughout the distraction and consolidation phase, leading to an improved healing outcome with a shortened healing time. These results suggest that a rate-varying clinical strategy could reduce the overall treatment time of DO and decrease the risk of complications related to the external fixator. |
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Keywords: | distraction osteogenesis rate-varying distraction finite element analysis mechano-regulatory tissue differentiation bone regeneration |
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