An optimization method for implantation parameters of individualized TKA tibial prosthesis based on finite element analysis and orthogonal experimental design

Abstract

Background: Individualized and accurate implantation of a tibial prosthesis during total knee arthroplasty (TKA) can assist in uniformly distributing the load and reducing the polyethylene wear to obtain a long-term prosthetic survival rate, but individualized and accurate implantation of a tibial prosthesis during TKA remains challenging. The purpose of this study was to optimize and individualize the positioning parameters of a tibial prosthesis to improve its accurate implantation using a new method of finite element analysis in combination with orthogonal experimental design. Methods: Ten finite element models of TKA knee joint were developed to optimize the implantation parameters (varus angle, posterior slope angle, and external rotation angle) of tibial prosthesis to reduce the peak value of the contact pressure on the polyethylene liner according to the method of finite element analysis in combination with orthogonal experimental design. The influence of implantation parameters on the peak value of the contact pressure on the polyethylene liner was evaluated based on a range analysis in orthogonal experimental design. Results: The optimal implantation parameters for tibial prosthesis included 0°varus, 1°posterior slope, and 4°e xternal rotation. Under these conditions, the peak value of the contact pressure on the polyethylene liner remained the smallest (16.37 MPa). Among the three parameters that affect the peak value of the contact pressure, the varus angle had the greatest effect (range = 6.70), followed by the posterior slope angle (range = 2.36), and the external rotation angle (range = 2.15). Conclusions: The optimization method based on finite element analysis and orthogonal experimental design can guide the accurate implantation of the tibial prosthesis, reducing the peak value of the contact pressure on the polyethylene liner. This method provides new insights into the TKA preoperative plan and biomechanical decisionmaking for accurately implanting TKA prosthesis.

Finite element analysis of the tibial component alignment in a transverse plane in total knee arthroplasty

“…Still, the optimal positioning of the tibial component has not been defined in the rotational plane, thus resulting in higher revision rates (Sahu and Kaviti, 2016;Wernecke et al, 2016). Dong et al (2020) used the finite element method to simulate the effect of different angles in the three planes (frontal, sagittal and axial) to determine accurate positioning of the tibial component simultaneously in the three planes. They chose to simulate the external rotation of the tibial component at 3°, 4° and 5° in transverse plane.…”

Crack Propagation in the Tibia Bone within Total Knee Replacement Using the eXtended Finite Element Method

“…Their elastic properties are reported in Table 1, which were used for modeling the tibia bone with and without the implant or total knee replacement (TKR). As listed in the table, elastic modulus (16.6 GPa and 2.4 GPa for cortical and cancellous bones, respectively) and Poisson ratio (0.3) of the bone tissue were taken from the 24-year-old male volunteer [29]. Moreover, elastic properties of the bones associated with two different ages (27-year-old female, 56-year-old female) were also extracted from [20], in which the elastic modulus of the cortical bone was set up as 15.3 GPa and 13.4 GPa for the 27-and 56-years old, respectively.…”

“…Moreover, elastic properties of the bones associated with two different ages (27-year-old female, 56-year-old female) were also extracted from [20], in which the elastic modulus of the cortical bone was set up as 15.3 GPa and 13.4 GPa for the 27-and 56-years old, respectively. A linear elastic law was also applied for the tibia implant with an elastic modulus of 117 GPa and a Poisson ratio of 0.3 [29]. Regarding the applied boundary conditions, the bottom part of the tibia model was clamped as a physiological boundary condition in standing posture.…”

Medial-lateral translational malalignment of the prosthesis on tibial stress distribution in total knee arthroplasty: A finite element analysis

“…To predict and avoid the problems mentioned above and thus improve the prognosis of surgery, the analytical approach (Jin et al, 1995), experimental measurement (Liau et al, 1999) and finite element analysis (Popescu et al, 2019;Dong et al, 2020;Park et al, 2021) (FEA) have been widely used in the field of orthopedics. Matsuda et al (1999) investigated the effect of varus tilt on contact stresses in total knee prostheses using electronic pressure sensors; Liau et al (1999) studied the effect of tibiofemoral joint contact alignment of knee prosthesis using Fuji pressure-sensitive film in an in vitro biomechanical test.…”