Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding

Bone & Joint Research

article

Byung W. Cho¹  Kyoung-Tak Kang²  Hyuck M. Kwon¹  Woo-Suk Lee¹  Ick H. Yang³  Ji H. Nam²  Yong-Gon Koh⁴  Kwan K. Park³ 

[1] Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine;Department of Mechanical Engineering, Yonsei University;Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine;Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital

关键词: Total knee arthroplasty;    Finite element analysis;    Anatomical tibial component;    Stress-shielding;    Medial proximal tibial bone loss;    anatomical tibial component;    tibial bone;    Total knee arthroplasty (TKA);    tibial components;    cortical bone;    strains;    finite element models;    finite element analysis;    Pearson correlation;    cancellous bone;   

DOI  :  10.1302/2046-3758.115.BJR-2021-0537.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThis study aimed to identify the effect of anatomical tibial component (ATC) design on load distribution in the periprosthetic tibial bone of Koreans using finite element analysis (FEA).Methods3D finite element models of 30 tibiae in Korean women were created. A symmetric tibial component (STC, NexGen LPS-Flex) and an ATC (Persona) were used in surgical simulation. We compared the FEA measurements (von Mises stress and principal strains) around the stem tip and in the medial half of the proximal tibial bone, as well as the distance from the distal stem tip to the shortest anteromedial cortical bone. Correlations between this distance and FEA measurements were then analyzed.ResultsThe distance from the distal stem tip to the shortest cortical bone showed no statistically significant difference between implants. However, the peak von Mises stress around the distal stem tip was higher with STC than with ATC. In the medial half of the proximal tibial bone: 1) the mean von Mises stress, maximum principal strain, and minimum principal strain were higher with ATC; 2) ATC showed a positive correlation between the distance and mean von Mises stress; 3) ATC showed a negative correlation between the distance and mean minimum principal strain; and 4) STC showed no correlation between the distance and mean measurements.ConclusionImplant design affects the load distribution on the periprosthetic tibial bone, and ATC can be more advantageous in preventing stress-shielding than STC. However, under certain circumstances with short distances, the advantage of ATC may be offset.

【 授权许可】

CC BY-NC