Finite element analysis: a comparison of an all-polyethylene tibial implant and its metal-backed equivalent

Thompson, S.M.; Yohuno, D.; Bradley, William Neil; Crocombe, A.D.

doi:10.1007/s00167-015-3923-y

Cited by 23 publications

(19 citation statements)

References 37 publications

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“…Thompson et al found that higher stress shielding (resorption) occurred around the keel and stem of the MBT, which revealed greater potential for bone loss in these areas. The APT implant had no areas of bone resorption (increased flexible resulted in less stress shielding) [17]. A similar outcome was also found by Scott et al, who reported that significant stress shielding is found in MBT cases, while increased bone density was found in APT cases, particularly in the bones immediately beneath the baseplate.…”

Section: Discussionsupporting

confidence: 55%

“…However, although the polyethylene prosthetic bone cement was generally in a high stress state, this was lower than its fatigue endurance limit [15]. Cement stress in other studies also reported increased compressive stress at the cement–cancellous bone interface for the APT implant [17]. …”

Section: Discussionmentioning

confidence: 99%

“…The total number of the polyethylene model was 262,457, and the total number of nodes was 54,888. A complete summary of the material properties of the bone and implant components is shown in Table 1 [15–17]. …”

Section: Methodsmentioning

confidence: 99%

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All-polyethylene tibial components in distal femur limb-salvage surgery: a finite element analysis based on promising clinical outcomes

et al. 2017

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BackgroundWhether all-polyethylene tibial (APT) components are beneficial to patients who received distal femur limb-salvage surgery lacks high-quality clinical follow-up and mechanical evidence. This study aimed to investigate the biomechanics of the distal femur reconstructed with APT tumor knee prostheses using finite element (FE) analysis based on our previous, promising clinical outcome.MethodsThree-dimensional FE models that use APT and metal-backed tibial (MBT) prostheses to reconstruct distal femoral bone defects were developed and input into the Abaqus FEA software version 6.10.1. Mesh refinement tests and gait simulation with a single foot both in the upright and 15°-flexion positions with mechanical loading were conducted. Stress distribution analysis was compared between APT and MBT at the two static positions.ResultsFor both prosthesis types, the stress was concentrated on the junction of the stem and shaft, and the maximum stress in the femoral axis base was more than 100 Mpa. The stress on the tibial surface was relatively distributed, which was 1–19 MPa. The stress on the tibial bone-cement layer of the APT prosthesis was approximately 20 times higher than that on the MBT prosthesis in the same region. The stress on the proximal tibial cancellous bone and cortical bone of the APT prosthesis was 3–5 times greater than that of the MBT prosthesis, and it was more distributed.ConclusionsAlthough the stress of bone-cement around the APT component is relatively high, the stress was better distributed at the polyethylene-cement-bone interface in APT than in MBT prosthesis, which effectively protects the proximal tibia in distal femur tumor knee prosthesis replacement. These results should be considered when selecting the appropriate tibial component for a patient, especially under the foreseeable conditions of osteoporosis.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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All-polyethylene tibial components in distal femur limb-salvage surgery: a finite element analysis based on promising clinical outcomes

et al. 2017

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“…While bone cement provides for stable fixation between the trabecular bone and implant, it also results in stress-shielding of the bone that is interdigitated with cement (Zhang, Cossey et al 2016). Trabecular bone distal to metal-backed tibial trays has been shown to be more stress shielded than all-polyethylene implants using computational modeling (Thompson, Yohuno et al 2015). Changes in peri-prosthetic tibial bone density may not always lead to complications, with good clinical outcomes achievable (Jaroma, Soininvaara et al 2016).…”

Section: Introductionmentioning

confidence: 99%

A modelling approach demonstrating micromechanical changes in the tibial cemented interface due to in vivo service

Srinivasan¹,

Miller

Mann

et al. 2017

Journal of Biomechanics

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Post-operative changes in trabecular bone morphology at the cement-bone interface can vary depending on time in service. This study aims to investigate how micromotion and bone strains change at the tibial bone-cement interface before and after cementation. This work discusses whether the morphology of the post-mortem interface can be explained by studying changes in these mechanical quantities. Three post-mortem cement-bone interface specimens showing varying levels of bone resorption (minimal, extensive and intermediate) were selected for this study Using image segmentation techniques, masks of the post-mortem bone were dilated to fill up the mould spaces in the cement to obtain the immediately post-operative situation. Finite element (FE) models of the post-mortem and post-operative situation were created from these segmentation masks. Subsequent removal of the cement layer resulted in the pre-operative situation. FE micromotion and bone strains were analyzed for the interdigitated trabecular bone. For all specimens micromotion increased from the post-operative to the post-mortem models (distally, in specimen 1: 0.1 to 0.5 μm; specimen 2: 0.2 to 0.8 μm; specimen 3: 0.27 to 1.62 μm). Similarly bone strains were shown to increase from post-operative to post-mortem (distally, in specimen 1: −185 to −389 με; specimen 2: −170 to −824 με; specimen 3: −216 to −1024 με). Post-mortem interdigitated bone was found to be strain shielded in comparison with supporting bone indicating that failure of bone would occur distal to the interface. These results indicate that stress shielding of interdigitated trabeculae is a plausible explanation for resorption patterns observed in post-mortem specimens.

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“…In previous FEA studies, cancellous bone stresses were examined to assess its mechanical performance. However, it has been demonstrated that bone is a highly heterogeneous material and stress itself does not have a strong meaning if it is not related to its strength, i.e., yield stress, which has been shown to be correlated to bone density (Completo et al, 2008; 360 MMMS 16,2 Perillo-Marcone et al, 2003;Thompson et al, 2016). Nonetheless, it has also been demonstrated, by means of an experimental study, that the von Mises criterion is not accurate in assessing cancellous bone performance.…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic bone response to axial loading following TKR

Ravishanker¹,

Rao

Pai

et al. 2019

MMMS

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Purpose The purpose of this paper is to investigate by means of finite element analysis (FEA), the effect of polyethylene insert thickness and implant material, under axial loading following TKA. Design/methodology/approach The 3D geometric model of bone was processed using the CT scan data by MIMICS (3matic Inc.), package. Implant components were 3D scanned and subsequently 3D modeled using ANSYS Spaceclaim and meshed in Hypermesh (Altair Hyperworks). The assembled, meshed bone-implant model was then input to ABAQUS for FE simulations, considering axial loading. Findings Polyethylene insert thickness was found to have very little or no significance (p>0.05) on the mechanical performance, namely, stress, strain and stress shielding of bone-implant system. Implant material was found to have a very significant effect (p<0.05) on the performance parameters and greatly reduced the high stress zones up to 60 percent on the tibial flange region and periprosthetic region of tibia. Originality/value Very few FEA studies have been done considering a full bone with heterogeneous material properties, to save computational time. Moreover, four different polyethylene insert thickness with a metal-backed and all-poly tibial tray was considered as the variables affecting the bone-implant system response, under static axial loading. The authors believe that considering a full bone shall lead to more precise outcomes, in terms of the response of bone-implant system, namely, stress, strains and stress shielding in the periprosthetic region, to loading.

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Finite element analysis: a comparison of an all-polyethylene tibial implant and its metal-backed equivalent

Cited by 23 publications

References 37 publications

All-polyethylene tibial components in distal femur limb-salvage surgery: a finite element analysis based on promising clinical outcomes

All-polyethylene tibial components in distal femur limb-salvage surgery: a finite element analysis based on promising clinical outcomes

A modelling approach demonstrating micromechanical changes in the tibial cemented interface due to in vivo service

Periprosthetic bone response to axial loading following TKR

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