Optimization of parameters for femoral component implantation during TKA using finite element analysis and orthogonal array testing

Abstract

BackgroundIndividualized and accurate implantation of a femoral component during total knee arthroplasty (TKA) is essential in achieving equal distribution of intra-articular stress and long-term survival of the prosthesis. However, individualized component implantation remains challenging. This study aimed to optimize and individualize the positioning parameters of a femoral component in order to facilitate its accurate implantation.MethodsUsing computer-simulated TKA, the positioning parameters of a femoral component were optimized individually by finite element analysis in combination with orthogonal array testing. Flexion angle, valgus angle, and external rotation angle were optimized in order to reduce the peak value of the pressure on the polyethylene liner of the prosthesis.ResultsThe optimal implantation parameters of the femoral component were as follows: 1° flexion, 5° valgus angle, and 4° external rotation. Under these conditions, the peak value of the pressure on the polyethylene liner surface was minimized to 16.46 MPa. Among the three parameters, the external rotation angle had the greatest effect on the pressure, followed by the valgus angle and the flexion angle.ConclusionFinite element analysis in combination with orthogonal array testing can optimize the implantation parameters of a femoral component for TKA. This approach would possibly reduce the wear of the polyethylene liner and prolong the survival of the TKA prosthesis, due to its capacity to minimize stress. This technique represents a new method for preoperative optimization of the implantation parameters that can achieve the best possible TKA outcome.

The effects of immediate programmed cryotherapy and continuous passive motion in patients after computer-assisted total knee arthroplasty: a prospective, randomized controlled trial

“…Pain has been defined as “an unpleasant sensory and emotional experience” associated with actual or potential tissue damage or described in terms of such damage [ 8 ]. Stiffness is affected by other factors after TKA, like early mobilization of the knee [ 9 ], implant position [ 10 ], rotational alignment [ 11 , 12 ], size of the implant, overloading of some compartments [ 13 ], and previous range of motion (ROM) [ 14 ]. Therefore, adequate pain management and control of localized swelling and stiffness after TKA has become a priority because it is essential for improving patient satisfaction, prevention of complications, and enhancing quality of life by faster recovery.…”

The Effects of Immediate Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial

“…Pain has been de ned as "an unpleasant sensory and emotional experience" associated with actual or potential tissue damage or described in terms of such damage [8]. Stiffness is affected by other factors after TKA, like early mobilisation of the knee [9], implant position [10], rotational alignment [11,12], size of the implant, overloading of some compartments [13], and previous range of motion (ROM) [14].…”

The Effects of Immediate Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial

“…Pain has been de ned as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage [8]. Stiffness is affected by other factors after TKA, like early mobilisation of the knee [9], implant position [10], rotational alignment [11,12], size of the implant, overloading of some compartments [13], fear of pain, general health [14], and previous range of motion (ROM) [15]. Therefore, adequate pain management and control of localized swelling and stiffness after TKA has become a priority because it is essential for improving patient satisfaction, prevention of complications, and enhancing quality of life by faster recovery.…”