Refining Bone Plate Design for Proximal Tibia Fractures: A Comparative Evaluation of Methods and Outcomes in Patient-Specific Approaches

This study aims to assess and rank the effectiveness of 3D reconstruction, parametric design, and generative design in creating cost-effective, timely, and clinically appropriate bone plates for proximal tibia fractures. Additive manufacturing (AM) now enables customized bone plates, enhancing treatment efficacy and reducing long-term complications. However, challenges such as prolonged design processes, compatibility issues, and high costs persist, making it crucial to compare design approaches to identify the most effective method for patient-specific bone plates. To accomplish the evaluation, Analytic Hierarchy Process (AHP) adopted with eleven design criteria, i.e., the adaptability, load capacity, manufacturability, design cost and speed, installation ease, durability, anatomical conformance, patient comfort, customization, and lightweight design was utilized to access these three design approaches. Specifically, finite element analysis (FEA) was used to support the load capacity criteria comparison by providing stress distribution for each design. The FEA results revealed that the 3D reconstructed plate exhibited the lowest stress at 256.7 MPa, while the generative and parametric designs registered higher stresses of 755.3 MPa and 363.4 MPa, respectively. The parametric design was identified as the optimal method with a score of 0.444, compared to 0.359 for 3D reconstruction and 0.197 for generative design. This ensures that patient care is optimized through the use of custom-tailored implants that are both effective and efficient.