Differences in Anatomy and Kinematics in Asian and Caucasian TKA Patients: Influence on Implant Positioning and Subsequent Loading Conditions in Mobile Bearing Knees

Abstract

The objective of our study was to determine the mechanical stress conditions under tibiofemoral loading with an overlay of knee kinematics in deep flexion on two different mobile bearing designs in comparison to in vivo failure modes. This study investigates the seldom but severe complication of fatigue failure of polyethylene components at mobile bearing total knee arthroplasty designs. Assuming a combination of a floor-based lifestyle and tibial malrotation as a possible reason for a higher failure rate in Asian countries we developed a simplified finite element model considering a tibiofemoral roll-back angle of 22° and the range of rotational motion of a clinically established floating platform design (e.motion FP) at a knee flexion angle of 120° in order to compare our results to failure modes found in retrieved implants. Compared to the failure mode observed in the clinical retrievals the locations of the occurring stress maxima as well as the tensile stress distribution show analogies. From our observations, we conclude that the newly introduced finite element model with an overlay of deep knee flexion (lateral roll-back) and considerable internally rotated tibia implant positioning is an appropriate analysis for knee design optimizations and a suitable method to predict clinical failure modes.

Comparison of Radiological Parameters between Normal and Patellar Dislocation Groups in Korean Population: A Rotational Profile CT-Based Study

“…In the absence of database for Asian population, most surgeons have to rely on the data obtained from different ethnic groups both for the diagnosis and treatment. It is, however, clear that Asian knees differ from those of their Western counterpart22–24). Table 6 shows the comparison of values of various parameters between the established literature based on Western population and the current study8,12,13,25–30).…”

Multiple Damage of the Tibial Polyethylene Insert in Knee Joint Prosthesis (Can Excellent Postoperative Outcome Be the Cause of Fracture of the Tibial Insert?) Case Report and Literature Review

“…Other authors reported revision rates related to implant failure in range from 0,073 to 0.94% [7,15,18].…”

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“…The evaluation of musculoskeletal joint kinematics and function ( 32 , 40 , 41 ) applying latest-stage in silico analysis methods like dynamic patient activity-based FEA simulation ( 42 ) and musculoskeletal modelling. Furthermore, augmented reality applications, artificial intelligence algorithms, and widespread retrospective clinical data files, allows for a better understanding of the expected success of an intended treatment or procedure for different patient phenotypes (cluster).…”