Multi-scale finite element model of growth plate damage during the development of slipped capital femoral epiphysis.

Slipped capital femoral epiphysis (SCFE) is one of the most common disorders of adolescent hips. A number of works have related the development of SCFE to mechanical factors. Due to the difficulty of diagnosing SCFE in its early stages, the disorder often progresses over time, resulting in serious side effects. Therefore, the development of a tool to predict the initiation of damage in the growth plate is needed. Because the growth plate is a heterogeneous structure, to develop a precise and reliable model, it is necessary to consider this structure from both macro- and microscale perspectives. Thus, the main objective of this work is to develop a numerical multi-scale model that links damage occurring at the microscale to damage occurring at the macroscale. The use of this model enables us to predict which regions of the growth plate are at high risk of damage. First, we have independently analyzed the microscale to simulate the microstructure under shear and tensile tests to calibrate the damage model. Second, we have employed the model to simulate damage occurring in standardized healthy and affected femurs during the heel-strike stage of stair climbing. Our results indicate that on the macroscale, damage is concentrated in the medial region of the growth plate in both healthy and affected femurs. Furthermore, damage to the affected femur is greater than damage to the healthy femur from both the micro- and macrostandpoints. Maximal damage is observed in territorial matrices. Furthermore, simulations illustrate that little damage occurs in the reserve zone. These findings are consistent with previous findings reported in well-known experimental works.

A damage model for the growth plate: application to the prediction of slipped capital epiphysis.

Despite slipped capital femoral epiphysis (SCFE) being one of the most common disorders of the adolescent hip, its early diagnosis is quite difficult. The main objective of this work is to apply an interface damage model to predict the failure of the bone-growth plate-bone interface. This model allows to evaluate the risk of development of SCFE and to investigate the range of mechanical properties of the physis that may cause slippage of the plate. This paper also studies the influence of different geometrical parameters and body weight of the patient on the development of SCFE. We have demonstrated, thanks to the proposed model, that higher physeal sloping and posterior sloping angles are associated to a higher probability of development of SCFE. In a similar way, increasing body weight results in a more probable slippage.