Computational study on the effect of malalignment of the tibial component on the biomechanics of total knee arthroplasty

Suh, DS; Kt, Kang; Son, Jung–Woo; Or, Kwon; Baek, Changhyun; Yg, Koh

doi:10.1302/2046-3758.611.bjr-2016-0088.r2

Cited by 29 publications

(24 citation statements)

References 34 publications

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“…Our study found that the KA tibial plateau was less stable than the MA and valgus tibial cut when there was no sclerosis in the medial tibia. Previous studies [13, 21, 29, 30] have shown that the tibial plateau had the worst stability in the absence of sclerosis after 2.5° varus tibial cut [30] compared to 3°varus tibial cut [12, 13]. This is consistent with the results of our study comparing the prosthesis stability of the three groups without sclerosis.…”

Section: Discussionsupporting

confidence: 92%

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Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty

Gao

Yang

et al. 2019

BMC Musculoskelet Disord

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BackgroundDespite potential for improving patient outcomes, studies using three-dimensional measurements to quantify proximal tibial sclerotic bone and its effects on prosthesis stability after total knee arthroplasty (TKA) are lacking. Therefore, this study aimed to determine: (1) the distribution range of tibial sclerotic bone in patients with severe genu varum using three-dimensional measurements, (2) the effect of the proximal tibial sclerotic bone thickness on prosthesis stability according to finite-element modelling of TKA with kinematic alignment (KA), mechanical alignment (MA), and 3° valgus alignment, and (3) the effect of short extension stem augment utilization on prosthesis stability.MethodsThe sclerotic bone in the medial tibial plateau of 116 patients with severe genu varum was measured and classified according to its position and thickness. Based on these cases, finite-element models were established to simulate 3 different tibial cut alignments with 4 different thicknesses of the sclerotic bone to measure the stress distribution of the tibia and tibial prosthesis, the relative micromotion beneath the stem, and the influence of the short extension stem on stability.ResultsThe distribution range of proximal tibial sclerotic bone was at the anteromedial tibial plateau. The models were divided into four types according to the thickness of the sclerotic bone: 15 mm, 10 mm, 5 mm, and 0 mm. The relative micromotion under maximum stress was smallest after MA with no sclerotic bone (3241 μm) and largest after KA with 15 mm sclerotic bone (4467 μm). Relative micromotion was largest with KA and smallest with MA in sclerotic models with the same thickness. Relative micromotion increased as thickness of the sclerotic bone increased with KA and MA (R = 0.937, P = 0.03 and R = 0.756, P = 0.07, respectively). Relative micromotion decreased with short extension stem augment in the KA model when there was proximal tibial sclerotic bone.ConclusionsThe influence of proximal tibial sclerotic bone on prosthesis’s stability is significant, especially with KA tibial cut. Tibial component’s short extension stem augment can improve stability.

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Section: Discussionsupporting

confidence: 92%

“…Since a motion model was not used, the profile above the spacer could be omitted and replaced with a platform [17, 18]. We neglected the element of bone cement as in previous research models [12, 19, 20].…”

Section: Methodsmentioning

confidence: 99%

Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty

Gao

Yang

et al. 2019

BMC Musculoskelet Disord

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“…7). Such studies have been performed in both FE and MBD models (Essner et al, 2011;Kang et al, 2018a;Kang et al, 2016;Kang et al, 2017f;Kang et al, 2018b;Kang et al, 2018c;Kang et al, 2018e;Kang et al, 2019b;Kang et al, 2018g;Kuriyama et al, 2014;Marra et al, 2018;Suh et al, 2017;Thompson et al, 2011). Investigations have included pre-or post-clinical evaluation for translation and rotation in coronal and sagittal planes.…”

Section: Application Of Computational Simulation In Pre-or Post-clinimentioning

confidence: 99%

“…Many studies have also examined misalignment of the tibial component (Kang, Kwon, Son, Kwon, Lee and Koh, 2018a;Kang et al, 2018d;Kang, Kwon, Son, Kwon, Lee and Koh, 2018g;Kuriyama, Ishikawa, Furu, Ito and Matsuda, 2014;Suh, Kang, Son, Kwon, Baek and Koh, 2017). Kuriyama et al evaluated traction forces in the LCL and MCL with a malrotated tibial component during squatting using computational simulation (Kuriyama, Ishikawa, Furu, Ito and Matsuda, 2014).…”

Section: Application Of Computational Simulation In Pre-or Post-clinimentioning

confidence: 99%

Computational biomechanics of knee joint arthroplasty : a review

Kang

Koh

Lee

et al. 2020

Mechanical Engineering Reviews

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Computational models have been widely used for more than four decades to evaluate the mechanical behavior of knee joint arthroplasty. Validated computational models provide a virtual platform to develop optimal articular surfaces which achieve desired implant characteristics. This review paper provides a comprehensive overview of the computational models available to represent knee joint arthroplasty. A brief overview of knee joint anatomy and arthroplasty is provided, followed by computational model development techniques. Use of the computational models in development of knee joint arthroplasty and pre-or post-clinical evaluation is summarized. This review paper presents current modeling capabilities for implant design and stability, with further suggestions for studying the performance of implants on a population level. However, simulations must include closely corroborated multi-domain analysis in order to account for real-life variability.

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“…Coronal alignment of the TKA has been shown to influence the load in the medial compartment, which my effect the wear of the polyethylene, and ligamentous stability, laterally. 11 Femoral rotation has been demonstrated to have a direct effect on the force transmitted through the medial tibiofemoral compartment and patellofemoral joint, with internal rotation increasing the force through these compartments. 12 The majority of TKA designs sacrifice the anterior cruciate ligament, and others also sacrifice the PCL, which changes the joint kinematics.…”

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confidence: 99%