Insert conformity variation affects kinematics and wear performance of total knee replacements

Zhang, Qida; Chen, Zhenxian; Zhang, Jing; Hu, Jiayu; Peng, Yonghan; Fan, Xunjian; Zhang, Jin

doi:10.1016/j.clinbiomech.2019.03.016

Cited by 25 publications

(27 citation statements)

References 30 publications

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“…Revisions for wear decreased in all 3 registries, which is also a finding reported by others (Le et al 2014, Sharkey et al 2014, Thiele et al 2015. Proposed reasons for this decrease are improvements in polyethylene by modified sterilization and packaging methods (Faris et al 2006), increased use of highly cross-linked polyethylene (de Steiger et al 2015), increased bearing conformity (Zhang et al 2019), altered knee kinematics with femoral component design changes (Gilbert et al 2014), or decreased tibial baseplate roughness and improved polyethylene locking mechanisms (Sisko et al 2017).…”

Section: Discussionsupporting

confidence: 64%

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Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

et al. 2020

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Background and purpose — Studies describing time-related change in reasons for knee replacement revision have been limited to single regions or institutions, commonly analyze only 1st revisions, and may not reflect true caseloads or findings from other areas. We used revision procedure data from 3 arthroplasty registries to determine trends and differences in knee replacement revision diagnoses. Patients and methods — We obtained aggregated data for 78,151 revision knee replacement procedures recorded by the Swedish Knee Arthroplasty Register (SKAR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and the Kaiser Permanente Joint Replacement Registry (KPJRR) for the period 2003–2017. Equivalent diagnosis groups were created. We calculated the annual proportions of the most common reasons for revision. Results — Infection, loosening, and instability were among the 5 most common reasons for revision but magnitude and ranking varied between registries. Over time there were increases in proportions of revisions for infection and decreases in revisions for wear. There were inconsistent proportions and trends for the other reasons for revision. The incidence of revision for infection showed a uniform increase. Interpretation — Despite some differences in terminology, comparison of registry-recorded revision diagnoses is possible, but defining a single reason for revision is not always clear-cut. There were common increases in revision for infection and decreases in revision for wear, but variable changes in other categories. This may reflect regional practice differences and therefore generalizability of studies regarding reasons for revision is unwise.

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Section: Discussionsupporting

confidence: 64%

“… 2015 ), increased bearing conformity (Zhang et al. 2019 ), altered knee kinematics with femoral component design changes (Gilbert et al. 2014 ), or decreased tibial baseplate roughness and improved polyethylene locking mechanisms (Sisko et al.…”

Section: Discussionmentioning

confidence: 99%

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

et al. 2020

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“…18 Three deformable contact models were defined; one each between the femoral component and the medial/lateral compartment of tibial insert, and a third one between the femoral component and the patellar button, based on the elastic foundation theory. 17,18,27,28 The contact forces for all contact pairs were calculated using a linear force-penetration volume law with a contact pressure module of 1.24 × 10 11 N/m 3 in this study. 18 For BCR TKA without ACL and PCR TKA (Figure 2(b) and (c)), the ligaments including the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the PCL, the posterior-medial capsule (PMC), and the medial and lateral patellar-femoral ligaments (MPFL, LPFL) were included in the knee joint model.…”

Section: Methodsmentioning

confidence: 99%

“…18 For BCR TKA without ACL and PCR TKA (Figure 2(b) and (c)), the ligaments including the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the PCL, the posterior-medial capsule (PMC), and the medial and lateral patellar-femoral ligaments (MPFL, LPFL) were included in the knee joint model. 17,18 In addition, ACL was included in the BCR knee joint model (Figure 2(a)). Ligaments were modeled as non-linear spring elements with a piecewise force displacement relationship.…”

Section: Methodsmentioning

confidence: 99%

“…Musculoskeletal (MSK) multi-body dynamics modeling, where the body is modeled as a multi-body mechanical system connected by joints and actuated by muscles, provides a reliable platform for investigating knee joint loading and kinematics. 17,18 Validated MSK models of activities of daily living provide a unique opportunity for understanding the influence of ACL retention within the same subjects and without the influence of other confounding variables. 19 These in turn could provide surgeons and manufacturers important guidance for improved surgical planning and prosthesis design.…”

Section: Introductionmentioning

confidence: 99%

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Leveraging subject-specific musculoskeletal modeling to assess effect of anterior cruciate ligament retaining total knee arthroplasty during walking gait

Zhang

Chen

Zhang

et al. 2020

Proc Inst Mech Eng H

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Bi-cruciate retaining total knee arthroplasty has several potential advantages including improved anteroposterior knee stability compared to contemporary posterior cruciate-retaining total knee arthroplasty. However, few studies have explored whether there is significant differences of knee biomechanics following bi-cruciate retaining total knee arthroplasty compared to posterior cruciate-retaining total knee arthroplasty. In the present study, subject-specific lower extremity musculoskeletal multi-body dynamics models for bi-cruciate retaining, bi-cruciate retaining without anterior cruciate ligament, and posterior cruciate-retaining total knee arthroplasty were developed based on the musculoskeletal modeling framework using force-dependent kinematics method and validated against in vivo telemetric data. The experiment data of two subjects who underwent total knee arthroplasty were obtained for the SimTK “Grand Challenge Competition” repository, and integrated into the musculoskeletal model. Five walking gait trials for each subject were used as partial inputs for the model to predict the knee biomechanics for bi-cruciate retaining, bi-cruciate retaining without anterior cruciate ligament, and posterior cruciate-retaining total knee arthroplasty. The results revealed significantly greater range of anterior/posterior tibiofemoral translation, and significantly more posterior tibial location during the early phase of gait and more anterior tibial location during the late phase of gait were found in bi-cruciate retaining total knee arthroplasty without anterior cruciate ligament when compared to the bi-cruciate retaining total knee arthroplasty. No significant differences in tibiofemoral contact forces, rotations, translations, and ligament forces between bi-cruciate retaining and posterior cruciate-retaining total knee arthroplasty during normal walking gait, albeit slight differences in range of tibiofemoral internal/external rotation and anterior/posterior translation were observed. The present study revealed that anterior cruciate ligament retention has a positive effect on restoring normal knee kinematics in bi-cruciate retaining total knee arthroplasty. Preservation of anterior cruciate ligament in total knee arthroplasty and knee implant designs interplay each other and both contribute to restoring normal knee kinematics in different types of total knee arthroplasty. Further evaluation of more demanding activities and subject data from patients with bi-cruciate retaining and posterior cruciate-retaining total knee arthroplasty via musculoskeletal modeling may better highlight the role of the anterior cruciate ligament and its stabilizing influence.

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Articular geometry can affect joint kinematics, contact mechanics, and implant‐bone micromotion in total ankle arthroplasty

Zhang

Chen

Zhao

et al. 2022

Journal Orthopaedic Research

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Implant loosening and bearing surface wear remain the most common failure problems of total ankle arthroplasty (TAA). One of the main factors leading to these problems is the nonphysiologic design of articular surfaces. The goals of this study were to reveal the effects of the anatomical medial‐lateral borders height differences, coronal and sagittal radii on the joint kinematics, contact mechanics, and implant‐bone micromotion in TAA. A previously developed and validated musculoskeletal (MSK) multibody dynamics (MBD) modeling method of TAA based on AnyBody generic MSK MBD model (five simulations for each implant) was used by combining with a finite element analysis. Five ankle implant models with different articular surface morphologies were created according to the anatomic characteristics of Chinese measurement data, marked as Implant A to E. The total ankle forces and motions during walking simulation were predicted by MSK MBD models and the contact mechanics of the bearing surface and the micromotion of the implant‐bone interface of TAA were predicted by FE models. Compared with Implant A, the internal‐external rotation in Implant E increased by 12.14%, the maximum of anterior‐posterior translation in Implant E increased by 5.62%, the maximum reduction of tibial micromotion in Implant E was 59.98%, and for talar, micromotion was 15.36%. The ankle implant with similar anatomic articular surface has the potential to allow patients to recover better motions and reduce the risk of early loosening. This study would provide design guidance for the development of new ankle implants and further advance the development of TAA. Clinical Significance: This study promoted the improvement of ankle implant design and made contributions to improve the service life of ankle implant and patient satisfaction.

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Insert conformity variation affects kinematics and wear performance of total knee replacements

Cited by 25 publications

References 30 publications

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

Variation and trends in reasons for knee replacement revision: a multi-registry study of revision burden

Leveraging subject-specific musculoskeletal modeling to assess effect of anterior cruciate ligament retaining total knee arthroplasty during walking gait

Articular geometry can affect joint kinematics, contact mechanics, and implant‐bone micromotion in total ankle arthroplasty

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