The sternum protects the intrathoracic organs and contributes to chest wall mechanics, which makes reconstruction after tumor resection, trauma, or infection a demanding biomechanical problem. This study presents an in silico workflow for preselecting materials for sternal implants before physical prototyping. After a virtual resection, an anatomically conformal implant was designed and candidate biomaterials were screened in CES Selector using density, elastic modulus, fatigue strength, fracture toughness, toxicity, medical grade suitability, and MRI safety. A representative subset of the screened candidates was then compared by finite element modeling in terms of stress transfer and deformation. Seventeen candidates met the screening criteria. Ti-13Nb-13Zr showed an elastic modulus of about 80 GPa, and the titanium-based candidates showed deformation values of about 0.96 to 1.03 mm, whereas GF PEEK reached about 1.74 mm. The stress shielding index also showed that titanium-based materials remained on the implant-dominant side, while polymer-based materials shifted stress transfer toward bone. Taken together, the findings suggest that Ti-13Nb-13Zr offers the best overall balance for load-bearing sternal reconstruction, whereas PEEK-based systems may be more suitable within the present model for hybrid or adjunct designs. The proposed workflow can support early implant planning and guide future experimental and clinical studies.
Kutbay et al. (Sun,) studied this question.