Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement

Pegg, Elise; Walter, Jonathan P.; Mellon, Stephen; Pandit, Hemant; Murray, David; D’Lima, Darryl D.; Fregly, Benjamin J.; Gill, H. S.

doi:10.1002/jor.22283

Cited by 61 publications

(56 citation statements)

References 34 publications

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“…Kuwashima et al investigated the effect of mechanical alignment, which is correlated with the joint line elevation, following medial UKA of the tibial compartment . To preserve the joint line, the surgeon should generally resect the tibial bone 4 mm from the bony surface of the tibia compartment . However, the degree of chondral defects often depends on the condition of the individual patient.…”

Section: Discussionmentioning

confidence: 99%

“…The PE insert was modeled as an elastoplastic material, and the implant components were modeled as linear elastic isotropic materials (Table ). In developing the joint line FE model, we referred to a previous study .…”

Section: Methodsmentioning

confidence: 99%

“…Accurate in silico evaluations of knee joint replacements are a valuable tool for clinical assessment . However, most of the previous FE studies have focused on stresses and strains in the tibial bone, which are presumably related to the coronal malalignments of the tibial component . The baseline FE models in these studies are limited to UKA and tibia modeling under static loading.…”

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confidence: 99%

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Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

Kwon

Kang

Son

et al. 2016

Journal Orthopaedic Research

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Unicompartmental knee arthroplasty (UKA) is an effective surgical technique for pain relief and functional restoration in patients with localized osteoarthritis of the knee joint. However, the role of the joint line in UKA, especially its biomechanical effect, has not been previously investigated. This study numerically evaluates the effects of the joint line on the contact stresses in polyethylene (PE) inserts, articular cartilage, and lateral meniscus using the finite element (FE) analysis. The FE model for joint line was modeled as the orthogonal projection line from the medial tibial plateau to the anatomical axis. The joint line was varied from -6 to +6 mm in 2 mm intervals, and the seven FE models were analyzed and compared under ISO gait loading conditions. The contact stresses in the PE insert, articular cartilage, and lateral meniscus matched those of the reference joint line (0 mm) in the ±2 and ±4 mm joint line cases but significantly differed from the reference in the ±6 mm joint line cases. On the +6 mm joint line, the contact stress was greater on the PE insert than on the articular cartilage, whereas the reverse occurred on the -6 mm joint line. This study confirms the post-operative significance of joint line preservation in UKA implantation surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:347-352, 2017.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

Kwon

Kang

Son

et al. 2016

Journal Orthopaedic Research

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“…The difference observed may be a consequence of these reasons, alternatively it may relate to a bony response to high stresses in the corner of the tibial tray [24,25].…”

Section: Discussionmentioning

confidence: 99%

A semi-automated measurement technique for the assessment of radiolucency

Pegg

Kendrick

Pandit

et al. 2014

J. R. Soc. Interface.

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The assessment of radiolucency around an implant is qualitative, poorly defined and has low agreement between clinicians. Accurate and repeatable assessment of radiolucency is essential to prevent misdiagnosis, minimize cases of unnecessary revision, and to correctly monitor and treat patients at risk of loosening and implant failure. The purpose of this study was to examine whether a semi-automated imaging algorithm could improve repeatability and enable quantitative assessment of radiolucency. Six surgeons assessed 38 radiographs of knees after unicompartmental knee arthroplasty for radiolucency, and results were compared with assessments made by the semi-automated program. Large variation was found between the surgeon results, with total agreement in only 9.4% of zones and a kappa value of 0.602; whereas the automated program had total agreement in 81.6% of zones and a kappa value of 0.802. The software had a 'fair to excellent' prediction of the presence or the absence of radiolucency, where the area under the curve of the receiver operating characteristic curves was 0.82 on average. The software predicted radiolucency equally well for cemented and cementless implants (p ¼ 0.996). The identification of radiolucency using an automated method is feasible and these results indicate that it could aid the definition and quantification of radiolucency.

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“…The causes of pain after UKR may be multifactorial. Inappropriate indications or bone overload are the most common causes 39,40 . Impingement, soft tissue irritation, cementing errors, pes anserinus bursitis or neuroma have been implicated.…”

Section: Painmentioning

confidence: 99%

Unicompartmental knee replacement

Takahashi

Pandit

2017

Journal of Arthroscopy and Joint Surgery

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Osteoarthritis (OA) of the knee is one of the most common causes of painful loss of mobility in middle and elderly aged population. OA is the main indication for knee joint replacement surgery. Unicompartmental knee replacement (UKR) is beneficial procedure for patient with degenerative OA which is limited in medial or lateral compartment providing reliable pain relief, improving function with significantly less morbidity and mortality as compared to total knee replacement. This editorial provides an overview of UKR, its relevance for Indian population, synopsis of results and future prospects. Abstract: Osteoarthritis (OA) of the knee is one of the most common causes of painful loss of mobility in middle and elderly aged population. OA is the main indication for knee joint replacement surgery. Unicompartmental knee replacement (UKR) is beneficial procedure for patient with degenerative OA which is limited in medial or lateral compartment providing reliable pain relief, improving function with significantly less morbidity and mortality as compared to total knee replacement. This editorial provides an overview of UKR, its relevance for Indian population, synopsis of results and future prospects.

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Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement

Cited by 61 publications

References 34 publications

Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

A semi-automated measurement technique for the assessment of radiolucency

Unicompartmental knee replacement

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