The influence of body weight index on initial stability of uncemented femoral knee protheses: A finite element study

Wan, Qian; Zhang, Aobo; Liu, Yang; Chen, Hao; Zhang, Jiangbo; Xue, Hao; Han, Qing; Wang, Jincheng

doi:10.1016/j.heliyon.2023.e13819

Cited by 5 publications

(5 citation statements)

References 53 publications

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“…In the current study, only BMI had a significant effect on the micromotions, with a higher BMI leading to higher micromotions. In line with this result, Wan et al concluded that a high BMI causes higher micromotions in both a gait and deep knee bend activity [9]. We also considered the effect of weight instead of BMI, which also was a statistically significant parameter in the linear mixed model.…”

Section: Discussionmentioning

confidence: 62%

“…However, in clinical practice, the outcome may be influenced by patient factors such as age, gender, and body mass index (BMI). For instance, several studies have investigated the influence of BMI on the outcomes of TKA [8][9][10]. While there has been controversy as to whether or not a high BMI negatively affects the primary fixation, a recent study has shown that a high BMI causes larger micromotions in reconstructions with metal implants [9].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, several studies have investigated the influence of BMI on the outcomes of TKA [8][9][10]. While there has been controversy as to whether or not a high BMI negatively affects the primary fixation, a recent study has shown that a high BMI causes larger micromotions in reconstructions with metal implants [9]. The influence of a high BMI on the primary fixation of a cementless PEEK tibial component, however, is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Patient-Related Factors on the Primary Fixation of PEEK and Titanium Tibial Components: A Population-Based FE Study

Post,

Bitter,

Briscoe

et al. 2024

Bioengineering

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Polyetheretherketone (PEEK) is of interest as implant material for cementless tibial total knee arthroplasty (TKA) components due to its potential advantages. One main advantage is that the stiffness of PEEK closely resembles the stiffness of bone, potentially avoiding peri-prosthetic stress-shielding. When introducing a new implant material for cementless TKA designs, it is essential to study its effect on the primary fixation. The primary fixation may be influenced by patient factors such as age, gender, and body mass index (BMI). Therefore, the research objectives of this finite element (FE) study were to investigate the effect of material (PEEK vs. titanium) and patient characteristics on the primary fixation (i.e., micromotions) of a cementless tibial tray component. A total of 296 FE models of 74 tibiae were created with either PEEK or titanium material properties, under gait and squat loading conditions. Overall, the PEEK models generated larger peak micromotions than the titanium models. Differences were seen in the micromotion distributions between the PEEK and titanium models for both the gait and squat models. The micromotions of all tibial models significantly increased with BMI, while gender and age did not influence micromotions.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Patient-Related Factors on the Primary Fixation of PEEK and Titanium Tibial Components: A Population-Based FE Study

Post,

Bitter,

Briscoe

et al. 2024

Bioengineering

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“…Three studies did not directly compare outcomes from the cementless with the cemented implant cohorts and so were removed [ 17 , 21 , 34 ]. One study was a finite element study which was not relevant to this meta‐analysis [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…The finite element analysis paper which did not meet the inclusion criteria for meta‐analysis showed that patients with higher BMI caused additional strain and micromotion between the prosthesis and femur; this suggested certain gait activities could pose a risk for prosthesis stability in this population [ 39 ]. Cementless implants in knee arthroplasty enable stronger component fixation for obese patients as the porous implant covering can integrate directly with the bone to provide a mechanical interlock [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Cementless TKA use as an alternative to cemented TKA in high BMI patients: A systematic review and meta‐analysis

Le,

van Duren,

Ilo

et al. 2024

J. exp. orthop.

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PurposeObesity is prevalent, with nearly one‐third of the world's population being classified as obese. In patients with high body mass index (BMI)/body mass undergoing total knee arthroplasty (TKA), there is an increase in strain placed on the implant fixation interfaces. As such, component fixation is a potential concern when performing TKA in the obese patient. To address the growing concerns around the longevity of implant fixation, some have advocated cementless over cemented fixation. However, there is no clear consensus on whether a cementless fixation has more favourable outcomes. The aim of this paper was to present a systematic review and meta‐analysis of the existing evidence to establish if cementless TKA has a lower rate of aseptic loosening in high BMI patients when compared to cemented TKA procedures.MethodsA systematic review was performed, and the following databases Medical Literature Analysis and Retrieval System Online (1946 to date), PubMed (1966 to date) and Excerpta Medica Database (1974 to date) were searched. All studies comparing cementless to cemented TKA in patients with BMI > 30 were considered. Meta‐analysis compared aseptic loosening and all‐cause revision between cemented and uncemented implant use in BMI > 30 patients.ResultsThe search returned 91 articles in total; after duplicates were removed, the yield was 44 studies. Of the remaining studies that were assessed, three studies met the inclusion criteria for meta‐analysis. The pooled odds ratio for all‐cause revisions was 0.17 (95%, 0.08–0.36) in favour of uncemented implants (p < 0.01). The pooled odds ratio for aseptic loosening was 0.15 (95% confidence interval, 0.02–0.90) in favour of uncemented implants (p = 0.04).ConclusionsMeta‐analysis demonstrated a significant decrease in all‐cause revisions and revisions for aseptic loosening when using uncemented fixation in high BMI patients when compared to the use of cemented implants.Level of EvidenceThe level of evidence is 1 for our systematic review.

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The primary stability of a cementless PEEK femoral component is sensitive to BMI: A population-based FE study

Post,

Bitter,

Briscoe

et al. 2024

Journal of Biomechanics

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The influence of body weight index on initial stability of uncemented femoral knee protheses: A finite element study

Cited by 5 publications

References 53 publications

The Effect of Patient-Related Factors on the Primary Fixation of PEEK and Titanium Tibial Components: A Population-Based FE Study

The Effect of Patient-Related Factors on the Primary Fixation of PEEK and Titanium Tibial Components: A Population-Based FE Study

Cementless TKA use as an alternative to cemented TKA in high BMI patients: A systematic review and meta‐analysis

The primary stability of a cementless PEEK femoral component is sensitive to BMI: A population-based FE study

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