Biomechanical study of the tibia in knee replacement revision

Quilez, María Paz; Pérez, M.Á.; Seral-García, B.

doi:10.1016/j.recote.2015.07.006

Cited by 3 publications

(4 citation statements)

References 29 publications

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“…Only a few published computational biomechanical studies have discussed the primary stability of metaphyseal sleeves. Quilez et al, investigated the best method to manage tibial bone defects using different fixation systems. Part of the systems investigated was a tibial tray augmented with a sleeve with and without a stem.…”

Section: Discussionmentioning

confidence: 99%

“…Part of the systems investigated was a tibial tray augmented with a sleeve with and without a stem. The authors, used a CT based tibial geometry and inhomogeneous material properties obtained from a calibrated CT data . However, they assumed that the implant was bonded to the bone, and therefore did not investigate the primary stability of the implant.…”

Section: Discussionmentioning

confidence: 99%

“…However, they assumed that the implant was bonded to the bone, and therefore did not investigate the primary stability of the implant. The study was heavily focused on bone remodeling, and did not share any pre‐remodeling stress or strain data …”

Section: Discussionmentioning

confidence: 99%

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Influence of stems and metaphyseal sleeve on primary stability of cementless revision tibial trays used to reconstruct AORI IIB defects

Awadalla

Al-Dirini

O’Rourke

et al. 2019

Journal Orthopaedic Research

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Metaphyseal augments, such as sleeves, have been introduced to augment the fixation of revision total knee replacement (rTKR) components, and can be used with or without a stem. The effect of sleeve size in combination with stems on the primary stability and load transfer of a rTKR implant in AORI type IIB defects where the defect involves both condyles are poorly understood. The aim of this study was to examine the primary stability of revision tibial tray augmented with a sleeve in an AORI type IIB defect which involves both condyles with loss of cortical and cancellous bone. Finite element models were generated from computed tomography (CT) scans of nine individuals. All the bones used in the study had an AORI type IIB defect. The cohort included eight females (mean weight: 64 kg, height: 1.6 m). Material properties were sampled from CT data and assigned to the FE model. Joint contact forces for level gait, stair descent, and squat were applied. Stemless sleeved implants under various loading conditions were shown to have adequate primary stability in all AORI type IIB defects investigated. Adding a stem only marginally improved the primary stability of the implant but reduced the strain in the metaphysis compared to stemless implants. Once good initial mechanical stability was established with a sleeve, there was no benefit, in terms of primary stability or bone strains, from increasing sleeve size. This study suggests that metaphyseal sleeves, without a stem, can provide the required primary stability required by a rTKR tibial implant, to reconstruct an AORI type IIB defect. ß

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Influence of stems and metaphyseal sleeve on primary stability of cementless revision tibial trays used to reconstruct AORI IIB defects

Awadalla

Al-Dirini

O’Rourke

et al. 2019

Journal Orthopaedic Research

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show abstract

“…Unlike these reconstruction methods, metaphyseal sleeves allow for the filling of bone defects and direct fixation in one single step. They also provide an axial load transmission which prevents stress shielding and promotes bone apposition even in the presence of bone defects, decreasing, over other systems, bone resorption in the metaphysis [22]. Fixation near the joint, in combination with mobile bearing systems, provides axial and rotational stability [16].…”

Section: Introductionmentioning

confidence: 99%