Biomechanical comparison of titanium alloy additively manufactured and conventionally manufactured plate-screw constructs

ABSTRACT

Aim

To biomechanically compare the bending stiffness, strength, and cyclic fatigue of titanium additively manufactured (AM) and conventionally manufactured (CM) limited contact plates (LCP) of equivalent dimensions using plate-screw constructs.

Methods

Twenty-four 1.5/2.0-mm plate constructs (CM: n = 12; AM: n = 12) were placed under 4-point bending conditions. Data were collected during quasi-static single cycle to failure and cyclic fatigue testing until implants plastically deformed or failed. Bending stiffness, bending structural stiffness, and bending strength were determined from load–displacement curves. Fatigue life was determined as number of cycles to failure. Median test variables for each method were compared using the Wilcoxon rank sum test within each group. Fatigue data was also analysed by the Kaplan–Meier estimator of survival function.

Results

There was no evidence for a difference in bending stiffness and bending structural stiffness between AM and CM constructs. However, AM constructs exhibited greater bending strength (median 3.07 (min 3.0, max 3.4) Nm) under quasi-static 4-point bending than the CM constructs (median 2.57 (min 2.5, max 2.6) Nm, p = 0.006). Number of cycles to failure under dynamic 4-point bending was higher for the CM constructs (median 164,272 (min 73,557, max 250,000) cycles) than the AM constructs (median 18,704 (min 14,427, max 33,228) cycles; p = 0.02). Survival analysis showed that 50% of AM plates failed by 18,842 cycles, while 50% CM plates failed by 78,543 cycles.

Conclusion and clinical relevance

Additively manufactured titanium implants, printed to replicate a conventional titanium orthopaedic plate, were more prone to failure in a shorter fatigue period despite being stronger in single cycle to failure. Patient-specific implants made using this process may be brittle and therefore not comparable to CM orthopaedic implants. Careful selection of their use on a case/patient-specific basis is recommended.

KEYWORDS:

• 3D printed
• titanium
• additively manufactured
• conventionally manufactured
• strength
• fatigue

Acknowledgements

The design and technical support of the plate testing were done by the Massey University Engineering department. Statistical support was provided by Sebastian Rivera. The CAD of the AM plate was by Nathan Wilkinson (Nexus Engineering). The fabrication of the AM plate was by Warwick Downing and team (RAM3D). Funding support came from Healthy Pets New Zealand.

Disclosure statement

No potential conflict of interest was reported by the authors.