Customized reconstructive prosthesis design based on topological optimization to treat severe proximal tibia defect

A novel reconstructive prosthesis was designed with topological optimization (TO) and a lattice structure to enhance biomechanical and biological properties in the proximal tibia. The biomechanical performance was validated through finite element analysis (FEA) and biomechanical tests. The tibia with inhomogeneous material properties was reconstructed according to computed tomography images, and different components were designed to simulate the operation. Minimum compliance TO subject to a volume fraction constraint combined with a graded lattice structure was utilized to redesign the prosthesis. FEA was performed to evaluate the mechanical performances of the tibia and implants after optimization, including stress, micromotion, and strain energy. The results were analyzed by paired-samples t tests, and p