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

Cho, Byung Woo; Kang, Kyoung‐Tak; Kwon, Hyuck Min; Lee, Woo Suk; Yang, Ick Hwan; Nam, Ji Hyung; Koh, Yong‐Gon; Park, Kwan K.

doi:10.1302/2046-3758.115.bjr-2021-0537.r1

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Some finite element modeling studies have found higher tibial bone stresses with porous tibial components [ 37 , 38 ]. Other studies have shown that differences in tibial platform design result in different stresses on the bone [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Different Femoral Component Materials on Bone and Implant Response in Total Knee Arthroplasty: A Finite Element Analysis

Galas

Banci²,

Innocenti

2023

Materials

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Due to the high stiffness of the biomaterials used in total knee arthroplasty, stress shielding can lead to decreased periprosthetic bone mineral density and bone resorption. As different materials and 3D-printed highly porous surfaces are available for knee femoral components from the industry nowadays, this study aimed to compare the effects of two same-design cruciate-retaining femoral components, made with CoCr and titanium alloy, respectively, on periprosthetic bone stresses through a finite element model of the implanted knee in order to evaluate the induced stress shielding. Moreover, the effect of the cementless highly porous surface of the titanium implant was analyzed in comparison to the cemented interface of the CoCr implant. The von Mises stresses were analyzed in different periprosthetic regions of interest of the femur with different configurations and knee flexion angles. The titanium component induced higher bone stresses in comparison with the CoCr component, mostly in the medial compartment at higher knee flexion angles; therefore, the CoCr component led to more stress shielding. The model was revealed to be effective in describing the effects of different femoral component materials on bone stress, highlighting how a cementless, highly porous titanium femoral component might lead to less stress shielding in comparison to a cemented CoCr implant with significant clinical relevance and reduced bone resorption after total knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

The Effects of Different Femoral Component Materials on Bone and Implant Response in Total Knee Arthroplasty: A Finite Element Analysis

Galas

Banci²,

Innocenti

2023

Materials

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“…First, the walking loading conditions from our previous study were applied to validate the FE model. 22 Second, the FE model was validated by applying stand-up loading conditions corresponding to activities of daily living for a 0-degree flexion angle of the knee. 23 Third, a compressive loading condition corresponding to clinical relevance was used to evaluate the effect of the three stem lengths on various bone defects.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, three loading conditions were included: two for the validation of the FE model and one for model predictions for clinically relevant loading scenarios. First, the walking loading conditions from our previous study were applied to validate the FE model 22 . Second, the FE model was validated by applying stand-up loading conditions corresponding to activities of daily living for a 0° flexion angle of the knee 23 .…”

Section: Loading and Boundary Conditionsmentioning

confidence: 99%

Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study

Park,

Kang,

Kwon

et al. 2024

J Knee Surg

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The aim of this study was to investigate the biomechanical effects of stem extension with a medial tibial bone defect in primary total knee arthroplasty (TKA) on load distribution and stress in the proximal tibia using finite element (FE) analysis.FE simulations were performed on the tibia bone to evaluate the stress and strain on the tibia bone and bone cement. This was done to investigate the stress shielding effect, stability of the tibia plate, and the biomechanical effects in TKA models with various medial defects and different stem length models.The results demonstrated that in the bone defect model, the longer the stem, the lower the average von Mises stress on the cortical and trabecular bones. In particular, as the bone defect increased, the average von Mises stress on cortical and trabecular bones increased. The average increase in stress according to the size of the bone defect was smaller in the long stem than in the short stem. The maximal principal strain on the trabecular bone occurred mainly at the contact point on the distal end of the stem of the tibial implant. When a short stem was applied, the maximal principal strain on the trabecular bone was approximately 8% and 20% smaller than when a long stem was applied or when no stem was applied, respectively.The findings suggest that a short stem extension of the tibial component could help achieve excellent biomechanical results when performing TKA with a medial tibial bone defect.

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“…Most of the body's weight is held up by two bone joints. The joint between the patella and the femur allows forces from the quadriceps femoris to pass over the knee without causing friction [2]. The knee's medial ligament complex is made up of one large ligament, a group of thickenings and tendon attachments on the kneecap.…”

Section: Introductionmentioning

confidence: 99%

Interleukin-4 Enhances the Production of Anti-Inflammatory Macrophages That Inhibits the Growth of Osteoclasts to Improve Knee Functionality

Alzamily¹,

Yousif²,

Alsalman³

2022

JBB

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Background : The knee is one of the largest and most complicated joints in the body. Knee osteoarthritis is a common disease for many people in many countries, especially those who have an unbalanced and unhealthy lifestyle, where they suffer from pain and difficulty in movement. Given that treatments and medicines generally have side effects, it was possible to search for an alternative treatment that is safer and it has the greatest effect. Platelet-rich plasma therapy is an important and useful treatment by injecting it locally into the knee joint, which allows for repairing the damage in the joint and rebuilding it at the level of the microenvironment. Significant disappearance of symptoms the innate immune system stimulates interleukin-4, an anti-inflammatory cytokine secreted by the body in response to the inflammation that occurs in the affected area of the body, where it works to stimulate the repair of damage.Patients and procedure This non-randomized controlled pilot study included 32 patients (18 females and 14 males) with knee osteoarthritis and 16 healthy subjects (5 females and 11 male) from November 2021 to June 2022. All KOA patients diagnosed by orthopedic specialists were based on clinical treatment and radiological findings (X-rays). They were divided into two groups based on the type of PRP; they received: 21 patients received a single injection of pure-PRP in the knee joint and 11 patients received a single injection of LR-PRP in the knee joint. The PRP were received by patients was 4 ml in the case of both groups. The ages of the participants (patients and control group) ranged between 35-75 years old. Outcomes were measured at two points at baseline and six months after injection with IL-4 as an indicator. ResultsThe results of this study were showed that the concentration of IL-4 was significantly higher in KOA patients as compared to control subjects, and both the pure-PRP injected group and the LR-PRP injected group showed a significant decrease in the concentration of IL-4 after six weeks of intervention, but the pure-PRP injected group showed a higher reduction in the serum level of IL-4 as compared to the LR-PRP injected group. ConclusionsIn conclusion, pure-PRP and LR-PRP showed benefits in terms of inflammation reduction. In both groups, there was a significant reduction in the concentration of IL-4, but the pure-PRP gave a superior outcome as compared to the LR-PRP.

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

Cited by 6 publications

References 33 publications

The Effects of Different Femoral Component Materials on Bone and Implant Response in Total Knee Arthroplasty: A Finite Element Analysis

The Effects of Different Femoral Component Materials on Bone and Implant Response in Total Knee Arthroplasty: A Finite Element Analysis

Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study

Interleukin-4 Enhances the Production of Anti-Inflammatory Macrophages That Inhibits the Growth of Osteoclasts to Improve Knee Functionality

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