Using generative design and topology optimization to design a new attachment structure for the Nuss bar

Andrzej Milenin¹ , Piotr Kustra¹ , Krzysztof Muszka*¹ , Jerzy Dybich², Bartosz Czarnecki², Laura Gołąbek²

¹AGH University of Krakow, Faculty of Metals Engineering and Industrial Computer Science, al. A. Mickiewicza 30, 30-059 Krakow, Poland

²BHH Mikromed, 11 Porozumienia Dąbrowskiego 1980 St., 42-530 Dąbrowa Górnicza, Poland

DOI:

https://doi.org/10.7494/cmms.2026.2.1030

Abstract:

The aim of the study was to develop a new rib attachment structure for the Nuss implant, in which the design process was supported by numerical methods, namely generative design and topology optimization. The study utilized 316LVM surgical steel, for which the mechanical properties were determined through tensile testing. The Autodesk Fusion and SolidWorks 2022 computational environments were used for shape optimization. Multiple geometric variants were obtained within the framework of generative design; however, their complexity and their reliance on additive manufacturing limit their practical implementation. In contrast, topology optimization reduced the mass by 17–30% while maintaining mechanical strength and manufacturability through conventional milling. Design modifications introduced through consultations with surgeons improved the ergonomics of implant installation. The results indicate that integrating both methods provides an effective tool for designing lightweight, durable, and functional Nuss implant attachments, opening up new prospects for personalized thoracic surgery.

Cite as:

Milenin, A., Kustra, P., Muszka, K., Dybich, J., Czarnecki, B., & Gołąbek, L. (2026). Using generative design and topology optimization to design a new attachment structure for the Nuss bar. Computer Methods in Materials Science, 26(2), XX-XX. https://doi.org/10.7494/cmms.2026.2.1030

Article (PDF):

Accepted Manuscript – final pdf version coming soon

Keywords:

generative design, topology optimization, Finite Element Method, chest defect correction implants, stainless steel

Publication dates:

Received: 30.09.2025, Accepted: 06.07.2026, Published: 28.08.2026

Publication type:

Original scientific paper

References:

Abdullah, M. A. (2020). Topology optimization of acetabular cup by finite element simulation. Journal of Engineering and Management Sciences, 5(2), 22–34. https://doi.org/10.21791/IJEMS.2020.2.4

Adebomojo, M. (2023). Exploring finite element analysis and topology optimization for enhancing femoral prosthesis design. ResearchGate. https://doi.org/10.13140/RG.2.2.14278.24648

Autodesk. (2020). Fusion 360 Introduction to Generative Design. https://www.autodesk.com/autodesk-university/article/Fusion-360-Introduction-Generative-Design

Bendsøe, M. P., & Sigmund, O. (2004). Topology Optimization: Theory, Methods, and Applications (2nd ed.). Springer Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05086-6

Chang, P. Y., Hsu, Z.-Y., Chen, D.-P., Lai, J.-Y., & Wang, C.-J. (2008). Preliminary analysis of the forces on the thoracic cage of patients with pectus excavatum after the Nuss procedure. Clinical Biomechanics, 23(7), 881–885. https://doi.org/10.1016/j.clinbiomech.2008.02.010

Deb, K., Pratap, A., Agarwal, S., & Meyarivan, T. (2002). A fast and elitist multiobjective genetic algorithm: NSGA-II. IEEE Transactions on Evolutionary Computation, 6(2), 182–197. https://doi.org/10.1109/4235.996017

Gaynor, A. T., & Guest, J. K. (2016). Topology optimization considering overhang constraints: Eliminating sacrificial support material in additive manufacturing through design. Structural and Multidisciplinary Optimization, 54(5), 1157–1172. https://doi.org/10.1007/s00158-016-1551-x

Hebra A., Swoveland B., Egbert M. Tagge E. P., Georgeson K., Biemann Othersen H., Jr, & Nuss D. (2000). Outcome analysis of minimally invasive repair of pectus excavatum: Review of 251 cases. Journal of Pediatric Surgery, 35(2), 252–258. https://doi.org/10.1016/S0022-3468(00)90019-8

Koul, P. (2024). A review of generative design using machine learning for additive manufacturing. Advances in Mechanical and Materials Engineering, 41(1), 145–159. https://doi.org/10.7862/rm.2024.14

Mu, Z., & Liu, T. (2023). Additive Manufacturing and Topology Optimization in Orthopedic Implants. Highlights in Science, Engineering and Technology, 45, 345–349. https://doi.org/10.54097/hset.v45i.7488

Nakagawa Y., Uemura S., Nakaoka T., Yano T., & Tanaka N. (2008). Evaluation of the Nuss procedure using pre- and postoperative computed tomographic index. Journal of Pediatric Surgery, 43(3), 518–521. https://doi.org/10.1016/j.jpedsurg.2007.10.033

Nuss, D. (2005). Recent experiences with minimally invasive pectus excavatum repair “nuss procedure”. The Japanese Journal of Thoracic and Cardiovascular Surgery, 53(7), 338–344. https://doi.org/10.1007/s11748-005-0047-1

Nuss, D. (2008). Minimally invasive surgical repair of pectus excavatum. Seminars in Pediatric Surgery, 17(3), 209–217. https://doi.org/10.1053/j.sempedsurg.2008.03.003

Park, H. J., et al. (2012). Finite element analysis of chest wall mechanics. Journal of Thoracic and Cardiovascular Surgery, 143(2), 436–442.

Park, J., Ahn, S. J., Lee, H., & Noh, G. (2021). Implant placement in the removable mandibular advancement device for completely edentulous patients: a finite element study. Journal of Computational Design and Engineering, 8(1), 140–148. https://doi.org/10.1093/jcde/qwaa067

Pollák M., & Török J. (2022) Use of generative design tools in the production of design products using 3D printing technology. TEM Journal, 11(1), 249–255. https://doi.org/10.18421/TEM111-31

Rozvany, G. I. N. (2009). A critical review of established methods of structural topology optimization. Structural and Multidisciplinary Optimization, 37, 217–237. https://doi.org/10.1007/s00158-007-0217-0

Smit, T. (2023). Topology optimization of patient-specific spinal fusion implants [Doctoral thesis, Delft University of Technology]. ETH Zürich Repository. https://doi.org/10.3929/ethz-b-000650121

Dassault Systèmes. (2022). Topology Study. SOLIDWORKS Design Help 2022. https://help.solidworks.com/2022/english/solidworks/cworks/c_generative_design_study.htm

Xu, W., Liu, F., & Nassehi, A. (2024). Optimizing orthopaedic bone plates for directed energy deposition with generative design and topological optimization approaches. Procedia CIRP, 125, 272–277. https://doi.org/10.1016/j.procir.2024.08.047

Zhou, M., & Rozvany, G. I. N. (1991). The COC algorithm, Part II: Topological, geometrical and generalized shape optimization. Computer Methods in Applied Mechanics and Engineering, 89(1–3), 309–336. https://doi.org/10.1016/0045-7825(91)90046-9

Zubizarreta-Oteiza, J., Zimmermann, C. J., Thieringer, F. M., & Sharma, N. (2024). Harnessing generative design algorithms in cranioplasty. Transactions on Additive Manufacturing Meets Medicine, 6(1), 1803. https://doi.org/10.18416/AMMM.2024.24091803