A three-dimensional finite element analysis on the effects of implant materials and designs on periprosthetic tibial bone resorption

Park, Hyung Jun; Bae, Tae Soo; Kang, Soon Beom; Baek, Hyeong Ho; Chang, Moon Jong; Chang, Chong Bum

doi:10.1371/journal.pone.0246866

Cited by 13 publications

(10 citation statements)

References 28 publications

(55 reference statements)

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“…7 Similarly, variations in implant material and design choice have been shown to affect bone resorption. 8,9 Bone formation and resorption are controlled by osteoblast and osteoclast cell activity, each stimulated by multiple factors including localized strain gradient. [10][11][12] Models within the literature, such as Frost's mechanostat, Wolff's law, and Perren's strain theory explain how this mechanism influences the complex and dynamic distribution of mechanical properties in bone.…”

Section: Introductionmentioning

confidence: 99%

Total and partial knee arthroplasty implants that maintain native load transfer in the tibia

Munford

Stoddart

Liddle

et al. 2022

Bone & Joint Research

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Aims Unicompartmental and total knee arthroplasty (UKA and TKA) are successful treatments for osteoarthritis, but the solid metal implants disrupt the natural distribution of stress and strain which can lead to bone loss over time. This generates problems if the implant needs to be revised. This study investigates whether titanium lattice UKA and TKA implants can maintain natural load transfer in the proximal tibia. Methods In a cadaveric model, UKA and TKA procedures were performed on eight fresh-frozen knee specimens, using conventional (solid) and titanium lattice tibial implants. Stress at the bone-implant interfaces were measured and compared to the native knee. Results Titanium lattice implants were able to restore the mechanical environment of the native tibia for both UKA and TKA designs. Maximum stress at the bone-implant interface ranged from 1.2 MPa to 3.3 MPa compared with 1.3 MPa to 2.7 MPa for the native tibia. The conventional solid UKA and TKA implants reduced the maximum stress in the bone by a factor of 10 and caused > 70% of bone surface area to be underloaded compared to the native tibia. Conclusion Titanium lattice implants maintained the natural mechanical loading in the proximal tibia after UKA and TKA, but conventional solid implants did not. This is an exciting first step towards implants that maintain bone health, but such implants also have to meet fatigue and micromotion criteria to be clinically viable. Cite this article: Bone Joint Res 2022;11(2):91–101.

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Section: Introductionmentioning

confidence: 99%

Total and partial knee arthroplasty implants that maintain native load transfer in the tibia

Munford

Stoddart

Liddle

et al. 2022

Bone & Joint Research

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“…Since body weight is transmitted to the tibia through the tibial component in TKA, differences in implant characteristics can directly impact load distribution. Because cobalt-chromium alloys have a higher modulus of elasticity than Ti6Al4V alloys, stress-shielding occurs more in the surrounding bone, 12,29,30 and the thicker the baseplate the more likely bone loss will occur. 8 The shape of the component can also affect the distribution of load, which is related to the patient's anatomical geometry.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, finite element analysis (FEA) has been used in analyzing mechanical stimuli alterations according to the implant design, material, and surgical methods that affect stress-shielding in total joint replacement, 10,11 especially in TKA. Park et al 12 reported the association of periprosthetic tibial bone resorption with tibial component material, and Zhang et al 13 reported that the material and alignment of tibial component had a significant effect on the stress-shielding of the proximal tibia. In addition, Au et al 14 reported that the contribution of loading condition had an important effect on the stress-shielding near the tibial component.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty

Cho

Kang

Kwon

et al. 2022

Bone & Joint Research

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Aims This 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). Methods 3D 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. Results The 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. Conclusion Implant 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. Cite this article: Bone Joint Res 2022;11(5):252–259.

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“…The models were densely meshed by hypermesh (Altair, USA) with a 0.4‐mm element size using linear tetrahedral elements (Fig S1). A previous study showed that models with element sizes less than 1 mm have less than 3% error in strain 23 . The nodes of the coronoid and condylar regions in all directions were constrained to ensure boundary conditions.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Analysis of Different Framework Design, Framework Material and Bone Density in the Edentulous Mandible With Fixed Implant‐Supported Prostheses: A Three‐Dimensional Finite Element Study

Chen

et al. 2022

Journal of Prosthodontics

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Purpose The objective of this finite element study was to investigate the effect of different framework designs, framework materials, and bone densities on the stress distribution of fixed implant‐supported prostheses for edentulous mandibles. Materials and methods Under the condition of 2‐mm cortical bone, 16 models were created in the edentulous mandible to simulate different framework designs (1‐piece or 3‐piece frameworks) with different framework material (pure titanium, zirconia, polyetheretherketone, or carbon fiber‐reinforced polyetheretherketone) in‐high or low‐density trabecular bone. Then, vertical loading and oblique loading at 75° were applied to the anterior and posterior regions. The stress distribution and stress concentration region of implant and peri‐implant bone with different combinations were compared by finite element analysis. Results The use of the 1‐piece zirconia framework in high‐density trabecular bone improved stress distribution on implants and peri‐implant bone. The region of stress concentration is located in the buccal cervix of the distal implants and the distobuccal portion of the cortical bone in all models. To improve the stress distribution on fixed implant‐supported dentures for edentulous mandibles, the 1‐piece framework and zirconia represent the better combination. Conclusion Under the condition of 2‐mm cortical bone thickness, the full‐arch zirconia framework had minimum von Mises stress on implants and peri‐implant bone in all models, and high trabecular bone density greatly decreased the stress on cortical bone.

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A three-dimensional finite element analysis on the effects of implant materials and designs on periprosthetic tibial bone resorption

Cited by 13 publications

References 28 publications

Total and partial knee arthroplasty implants that maintain native load transfer in the tibia

Total and partial knee arthroplasty implants that maintain native load transfer in the tibia

Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty

Biomechanical Analysis of Different Framework Design, Framework Material and Bone Density in the Edentulous Mandible With Fixed Implant‐Supported Prostheses: A Three‐Dimensional Finite Element Study

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