A Validated Forward Solution Dynamics Mathematical Model of the Knee Joint: Can It Be an Effective Alternative for Implant Evaluation?

Khasian, Milad; Meccia, Bradley; LaCour, M; Komistek, Richard D.

doi:10.1016/j.arth.2020.06.017

Cited by 8 publications

(3 citation statements)

References 42 publications

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“…[47][48][49] These studies used motion analysis and ground reaction forces to calculate the forces and moments around the knee joint. Recently, new computer simulation studies with normal knee 50 and a PS TKA prothesis 51 have shown similar trends to previous findings, like the current study on MPK. However, in the current study, the lateral contact force and stress on the tibiofemoral joint at >60°of knee flexion were higher than those applied on the medial compartment in all three models.…”

Section: Discussionsupporting

confidence: 90%

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

et al. 2021

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Several concepts may be used to restore normal knee kinematics after total knee arthroplasty. One is a kinematically aligned (KA) technique, which restores the native joint line and limb alignment, and the other is the use of a medial pivot knee (MPK) design, with a ball and socket joint in the medial compartment. This study aimed to compare motions, contact forces, and contact stress between mechanically aligned (MA) and KA (medial tilt 3° [KA3] and 5° [KA5]) models in MPK. An MPK design was virtually implanted with MA, KA3, and KA5 in a validated musculoskeletal computer model of a healthy knee, and the simulation of motion and contact forces was implemented. Anteroposterior (AP) positions, mediolateral positions, external rotation angles of the femoral component relative to the tibial insert, and tibiofemoral contact forces were evaluated at different knee flexion angles. Contact stresses on the tibial insert were calculated using finite element analysis. The AP position at the medial compartment was consistent for all models. From 0° to 120°, the femoral component in KA models showed larger posterior movement at the lateral compartment (0.3, 6.8, and 17.7 mm in MA, KA3, and KA5 models, respectively) and larger external rotation (4.2°, 12.0°, and 16.8° in the MA, KA3, and KA5 models, respectively) relative to the tibial component. Concerning the mediolateral position of the femoral component, the KA5 model was positioned more medially. The contact forces at the lateral compartment of all models were larger than those at the medial compartment at >60° of knee flexion. The peak contact stresses on the tibiofemoral joint at 90° and 120° of knee flexion were higher in the KA models. However, the peak contact stresses of the KA models at every flexion angle were <20 MPa. The KA technique in MPK can successfully achieve near-normal knee kinematics; however, there may be a concern for higher contact stresses on the tibial insert.

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Section: Discussionsupporting

confidence: 90%

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

et al. 2021

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“…Additionally, 90-day readmissions following TJA create an enormous national healthcare economic burden, with approximately half of the annual expenses attributed to readmissions unrelated to the TJA [11,12]. However, improvements in technique and implant positioning may mitigate the costs of revisions [13][14][15][16][17], which are responsible for the greatest readmission, post-acute care, and long-term expenses [12]. With the incidence of revision arthroplasties projected to increase over the next several decades [18,19], there is an impetus to continue optimizing techniques and technologies to reduce revision and readmission rates following primary TJA.…”

Section: Introductionmentioning

confidence: 99%

Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty

et al. 2020

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Objective To determine the type and frequency of incidental findings detected on preoperative computed tomography (CT) imaging obtained for robotic-assisted joint replacements and their effect on the planned arthroplasty. Materials and methods All preoperative CT examinations performed for a robotic-assisted knee or total hip arthroplasty were obtained. This resulted in 1432 examinations performed between September 2016 and February 2020 at our institution. These examinations were initially interpreted by 1 of 9 fellowship-trained musculoskeletal radiologists. Using a diagnosis search, the examination reports were then reviewed to catalog all incidental findings and further classify as significant or non-significant findings. Demographic information was obtained. In those with significant findings, a chart review was performed to record the relevant workup, outcomes, and if the planned arthroplasty was affected. Results Incidental findings were diagnosed in 740 (51.7%) patients. Of those with incidental findings, 41 (5.5%) were considered significant. A significant finding was more likely to be detected in males (P = 0.007) and on the hip protocol CT (P = 0.014). In 8 patients, these diagnoses resulted in either delay or cancelation of the arthroplasty. A planned total hip arthroplasty was more likely to be altered as compared to a knee arthroplasty (P = 0.018). Conclusion Incidental findings are commonly detected by radiologists on preoperative CT imaging obtained for robotic-assisted joint replacement. Several were valuable findings and resulted in a delay or even cancelation of the planned arthroplasty after the detection of critical diagnoses, which if not identified may have resulted in devastating outcomes.

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“…The mesh structure of the talus implant was designed using periodically repeated unit cells. Numerous mesh structures have been studied and veri ed in the literature, demonstrating that the structure, shape, and unit cell size signi cantly contribute to the mechanical performance of customized implants [9,18].…”

Section: The Structure Design Simulation and Mechanical Testingmentioning

confidence: 99%

Post-traumatic Talus Avascular necrosis. Designing and additive manufacturing of talus implant as an alternative for leg amputation

Antounian,

Avagyan,

Ghaltaghchyan

et al. 2024

Preprint

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This study presents the design and development of a meshed implant intended for talus replacement surgery. Our focus was on a young adult patient who had sustained severe damage to the talus, resulting in avascular necrosis (AVN) and subsequent bone collapse. This condition caused persistent and debilitating pain, leading the medical team to consider amputation of the left foot at the ankle level as a last resort. Instead, we proposed an innovative approach involving the fabrication of a patient-specific implant specifically designed for pan-talar fusion. The implant was created using selective laser melting technology, which allowed for precise and accurate construction of the unique mesh structure. To ensure its mechanical integrity, we conducted uniaxial compression experiments, which confirmed that the proposed structure met all essential mechanical requirements, including compressive loading. The patient underwent regular monitoring for a period of 12 months. The meshed implant exhibited excellent osteoconductive properties, as evidenced by the successful ingrowth of bone into the mesh pores, resulting in a fusion between the implant and the surrounding bones.

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A Validated Forward Solution Dynamics Mathematical Model of the Knee Joint: Can It Be an Effective Alternative for Implant Evaluation?

Cited by 8 publications

References 42 publications

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

Incidental findings detected on preoperative CT imaging obtained for robotic-assisted joint replacements: clinical importance and the effect on the scheduled arthroplasty

Post-traumatic Talus Avascular necrosis. Designing and additive manufacturing of talus implant as an alternative for leg amputation

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