Finite element analysis of the tibial bone graft in cementless total knee arthroplasty

Totoribe, Koji; Chosa, Etsuo; Yamako, Go; Hamada, Hirofumi; Ouchi, Koki; Yamashita, Shutaro; Deng, Gang

doi:10.1186/s13018-018-0830-1

Cited by 17 publications

(11 citation statements)

References 27 publications

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“…An 8-mm tibial spacer was selected. As knee motion was not considered during the modeling, the upper contour of the spacer was omitted and replaced by a plateau [15,16]. Under the plateau, the thickness of bone cement was simulated as a 1-mm rigid body, which is in line with previous studies [17,18,19,20].…”

Section: Tibial Componentsmentioning

confidence: 86%

“…Second, the effect of soft tissues on the prosthesis was not considered in our models. As studies similar to ours did not also consider the effect of soft tissues [15,16,25], we primarily focused on the static knee prosthesis and tibial sclerotic bone, the elastic moduli of which are significantly larger than that of soft tissues. Therefore, our simulation still holds practical significance.…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous research data, the densities, Poisson's ratios, and elastic moduli of the tibial cortical bone, cancellous bone, plateau, placers, sclerotic bone, and bone cement were defined, as shown in Table 1 [16,17,21,22,23]. The coefficients of friction were measured: between the tibia and bone cement = 1, between the bone cement and tibial plateau = 0.4, and between other contact surfaces = 0.4 [17,18,19,20].…”

Section: Materials Propertiesmentioning

confidence: 99%

“…The direction of the force was parallel to the tibial 6 alignment (z-axis). The relative displacement of distal end of the prothesis and the stress distribution among the prosthesis and tibia were compared [16].…”

Section: Load and Boundary Conditionsmentioning

confidence: 99%

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Finite element analysis of the effect of tibial prosthesis extension stem length in total knee arthroplasty in the Chinese population

Li¹,

Gao²,

Ding³

et al. 2019

Preprint

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BackgroundThis study aimed to determine the longest usable range of tibial prosthesis extension stems in Chinese patients undergoing primary total knee arthroplasty and to analyze the effect of different stem lengths on prosthesis stability within this range.MethodsWe conducted three-dimensional modeling and simulated surgery in patients with genu varum to measure the longest usable range of tibial prothesis stems, identify impinged cortices under tibial posterior slope cut of 0° and 3°, and analyze factors influencing the longest stem length. We built finite element models according to the longest usable range of extension stems to simulate tibial prostheses with different stem lengths, measure the stress distribution of tibias and prostheses and the relative displacement of distal ends of prostheses, and investigate the effect of different stem extension lengths on prosthesis stability.ResultsWe simulated osteotomy with a tibial posterior slope cut of 0° and 3°, under which the maximum tibial prosthesis stem length was 83 mm (79±24 mm). The simulated tibial cut with a tibial posterior slope of 3° indicated the maximum tibial prosthesis stem length to be 83 mm (83±20 mm). According to the longest usable range of extension stems, we defined five groups for finite element analysis with 40-mm, 50-mm, 60-mm, 70-mm, and 80-mm stem lengths and analyzed each group for posterior slopes of 0° and 3°. The 80-mm stem length models showed minimum relative displacement of the distal end of tibial prosthesis (0°: 2.63, 1.61±0.05 µm; 3°: 1.48, 1.44±0.09 µm), whereas the 40-mm stem length models showed maximum relative displacement (0°: 3.16, 3.19±0.12 µm; 3°: 1.84, 1.81±0.07 µm). As the length of tibial prosthesis stems increased from 40 to 70 mm, the relative displacement of the distal end of prosthesis decreased for both posterior slopes but was insignificant when stem lengths increased to 70–80 mm.ConclusionsBased on the results, we suggest that using the longest tibial stem is not always necessarily a better option to increase stability, as the prosthesis shows greater stability in only a specific range of increased length but shows insignificant change when the length is greatly increased.

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Section: Tibial Componentsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Materials Propertiesmentioning

confidence: 99%

Section: Load and Boundary Conditionsmentioning

confidence: 99%

See 2 more Smart Citations

Finite element analysis of the effect of tibial prosthesis extension stem length in total knee arthroplasty in the Chinese population

Li¹,

Gao²,

Ding³

et al. 2019

Preprint

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show abstract

“…The tibial plateau rotation and the partition method shared the same y-axis, which was the tibia AP axis, and an 8-mm spacer was chosen. Since a motion model was not used, the profile above the spacer could be omitted and replaced with a platform [17, 18]. We neglected the element of bone cement as in previous research models [12, 19, 20].…”

Section: Methodsmentioning

confidence: 99%

Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty

Gao

Yang

et al. 2019

BMC Musculoskelet Disord

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BackgroundDespite potential for improving patient outcomes, studies using three-dimensional measurements to quantify proximal tibial sclerotic bone and its effects on prosthesis stability after total knee arthroplasty (TKA) are lacking. Therefore, this study aimed to determine: (1) the distribution range of tibial sclerotic bone in patients with severe genu varum using three-dimensional measurements, (2) the effect of the proximal tibial sclerotic bone thickness on prosthesis stability according to finite-element modelling of TKA with kinematic alignment (KA), mechanical alignment (MA), and 3° valgus alignment, and (3) the effect of short extension stem augment utilization on prosthesis stability.MethodsThe sclerotic bone in the medial tibial plateau of 116 patients with severe genu varum was measured and classified according to its position and thickness. Based on these cases, finite-element models were established to simulate 3 different tibial cut alignments with 4 different thicknesses of the sclerotic bone to measure the stress distribution of the tibia and tibial prosthesis, the relative micromotion beneath the stem, and the influence of the short extension stem on stability.ResultsThe distribution range of proximal tibial sclerotic bone was at the anteromedial tibial plateau. The models were divided into four types according to the thickness of the sclerotic bone: 15 mm, 10 mm, 5 mm, and 0 mm. The relative micromotion under maximum stress was smallest after MA with no sclerotic bone (3241 μm) and largest after KA with 15 mm sclerotic bone (4467 μm). Relative micromotion was largest with KA and smallest with MA in sclerotic models with the same thickness. Relative micromotion increased as thickness of the sclerotic bone increased with KA and MA (R = 0.937, P = 0.03 and R = 0.756, P = 0.07, respectively). Relative micromotion decreased with short extension stem augment in the KA model when there was proximal tibial sclerotic bone.ConclusionsThe influence of proximal tibial sclerotic bone on prosthesis’s stability is significant, especially with KA tibial cut. Tibial component’s short extension stem augment can improve stability.

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Computer Simulation of the Knee Joint

Kuriyama

2024

Advances in Total Knee Arthroplasty

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Finite element analysis of the tibial bone graft in cementless total knee arthroplasty

Cited by 17 publications

References 27 publications

Finite element analysis of the effect of tibial prosthesis extension stem length in total knee arthroplasty in the Chinese population

Finite element analysis of the effect of tibial prosthesis extension stem length in total knee arthroplasty in the Chinese population

Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty

Computer Simulation of the Knee Joint

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