Computational analysis of customized cruciate retaining total knee arthroplasty restoration of native knee joint biomechanics

Koh, Yong‐Gon; Lee, Jin‐Ah; Chung, Pill Ku; Kang, Kyoung‐Tak

doi:10.1111/aor.13382

Cited by 10 publications

(9 citation statements)

References 44 publications

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“…Concerning knee kinematics, it has been reported that customized implants achieve kinematics that are more close to those of the native knee joint compared to off-the-shelf implants [ 90 – 92 ]. A study investigating contact stresses on the polyethyene using finite element models reported that customized implants had decreased contact stresses under gait cycle conditions [ 90 ].…”

Section: Resultsmentioning

confidence: 99%

Contemporary knee arthroplasty: one fits all or time for diversity?

Beckmann,

Meier,

Benignus

et al. 2021

Arch Orthop Trauma Surg

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Introduction Total knee arthroplasty (TKA) has historically been the preferred solution for any type of knee osteoarthritis, independently of the number of compartments involved. In these days of patient-specific medicine, mono-compartmental disease could also be approached with a more individualized treatment, such as partial knee arthroplasty (PKA). Off-the-shelf (OTS) implants are often the compromise of averages and means of a limited series of anatomical parameters retrieved from patients and the pressure of cost control by limited inventory. Personalized medicine requires respect and interest for the individual shape and alignment of each patient. Materials and methods A Pubmed and Google Scholar search were performed with the following terms: “patient-specific knee” and “arthroplasty” and “custom implant” and “total knee replacement” and “partial knee replacement” and “patellofemoral knee replacement” and “bicompartmental knee replacement”. The full text of 90 articles was used to write this narrative review. Results Unicondylar, patellofemoral and bicompartmental knee arthroplasty are successful treatment options, which can be considered over TKA for their bone and ligament sparing character and the superior functional outcome that can be obtained with resurfacing procedures. For TKA, where compromises dominate our choices, especially in patients with individual variations of their personal anatomy outside of the standard, a customized implant could be a preferable solution. Conclusion TKA might not be the only solution for every patient with knee osteoarthritis, if personalized medicine wants to be offered. Patient-specific mono-compartmental resurfacing solutions, such as partial knee arthroplasty, can be part of the treatment options proposed by the expert surgeon. Customized implants and personalized alignment options have the potential to further improve clinical outcome by identifying the individual morphotype and respecting the diversity of the surgical population.

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Section: Resultsmentioning

confidence: 99%

Contemporary knee arthroplasty: one fits all or time for diversity?

Beckmann,

Meier,

Benignus

et al. 2021

Arch Orthop Trauma Surg

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“…A patient-specific TKA was developed using an existing 3D knee-joint model and the computed tomography (CT) and magnetic resonance imaging (MRI) of a healthy 36-year-old male with a normal knee condition (mechanical femoral tibial angle: varus 1°) [21,22,23,24,25]. The patient-specific TKA model was designed with actual anatomical geometries (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Optimal Design of Patient-Specific Total Knee Arthroplasty for Improvement in Wear Performance

Koh

Jung

Hong

et al. 2019

JCM

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Life expectancy is on the rise and, concurrently, the demand for total knee arthroplasty (TKA), which lasts a lifetime, is increasing. To meet this demand, improved TKA designs have been introduced. Recent advances in radiography and manufacturing techniques have enabled the production of patient-specific TKA. Nevertheless, concerns regarding the wear performance, which limit the lifespan of TKA, remain to be addressed. This study aims at reducing the wear in patient-specific TKA using design optimization and parametric three-dimensional (3D) finite-element (FE) modelling. The femoral component design was implemented in a patient-specific manner, whereas the tibial insert conformity remained to be determined by design variables. The gait cycle loading condition was applied, and the optimized model was validated by the results obtained from the experimental wear tests. The wear predictions were iterated for five million gait cycles using the computational model with force-controlled input. Similar patterns for internal/external rotation and anterior/posterior translation were observed in both initial and optimal models. The wear rates for initial and optimal models were recorded as 23.2 mm3/million cycles and 16.7 mm3/million cycles, respectively. Moreover, the experimental wear rate in the optimal design was 17.8 mm3/million cycles, which validated our optimization procedure. This study suggests that tibial insert conformity is an important factor in influencing the wear performance of patient-specific TKA, and it is capable of providing improved clinical results through enhanced design selections. This finding can boost the future development of patient-specific TKA, and it can be extended to other joint-replacement designs. However, further research is required to explore the potential clinical benefits of the improved wear performance demonstrated in this study.

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“…Yong‐Gon Koh et al of the Yonsei Sarang Hospital, Seoul, Republic of Korea assessed whether customized prosthesis better preserves the native knee joint kinematics and provides lower contact stress on the polyethylene (PE) insert owing to the wider bone preservation than that of standard off‐the‐shelf prosthesis in posterior cruciate‐retaining type total knee arthroplasty (TKA). Validated finite element models were developed to evaluate the knee joint kinematics and contact stress on the PE insert after TKA with customized and standard off‐the‐shelf (OTS) prostheses as well as in the normal healthy knee.…”

Section: Orthopedic Supportmentioning

confidence: 99%

Artificial Organs 2019: A year in review

Malchesky¹

2020

Artificial Organs

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In this Editor’s Review, articles published in 2019 are organized by category and summarized. These provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders “to foster communications in the field of artificial organs on an international level.” Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer‐reviewed Special Issues this year included contributions from the 14th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr Akif Undar, and the 26th Congress of the International Society for Mechanical Circulatory Support edited by Dr Minoru Ono and Dr Francesco Moscato. Additionally, important editorials highlighted the need for sustainability in hemodialysis, challenges and opportunities in mechanical circulatory support, progress in artificial pancreas development, historical perspectives on ventilators and dialysis, tissue engineering for cardiac support, and regional updates from India and China. Our Pioneer Series continues to highlight the many researchers who created this field of study. This year we debuted a new series entitled “Recent Progress in Artificial Organs” prepared by Vakhtang Tchantchaleishvili and Elizabeth Maynes of Thomas Jefferson University, Philadelphia, PA, USA. This series highlights recent advances and new developments in the field. We take this time also to express our gratitude to our authors for contributing their work to this journal. We offer our very special thanks to our reviewers who give so generously of their time and expertise to review, critique, and especially provide meaningful suggestions to the author’s work. Without our dedicated expert reviewers, the quality expected from such a journal would not be possible. We also express our special thanks to our Publisher, John Wiley & Sons, for their expert attention and support in the production Artificial Organs. We look forward to reporting further advances in the coming years.

show abstract

Computational analysis of customized cruciate retaining total knee arthroplasty restoration of native knee joint biomechanics

Cited by 10 publications

References 44 publications

Contemporary knee arthroplasty: one fits all or time for diversity?

Contemporary knee arthroplasty: one fits all or time for diversity?

Optimal Design of Patient-Specific Total Knee Arthroplasty for Improvement in Wear Performance

Artificial Organs 2019: A year in review

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