Numerical modelling of the weight-bearing total knee joint replacement and usage in practice

Dank, J.; Nedoma, Jiří; Hlaváček, Ivan; Vavřík, P; Denk, F

doi:10.1016/j.matcom.2007.01.013

Cited by 5 publications

(3 citation statements)

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“…According to the results, the outward condyles of the knee experienced higher pressure [202]. Sharma and coauthors computed the femoro-polyethylene contact pressure in total knee arthroplasty (TKA) using fluoroscopic images, CT scans, and Mechanical Desktop (Autodesk Inc, San Rafael, CA, USA).…”

Section: Pathomechanical Modeling and Clinical Applicationsmentioning

confidence: 99%

Recent Advances in Computational Mechanics of the Human Knee Joint

Kazemi

Dabiri

2013

Computational and Mathematical Methods in Medicine

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Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

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Section: Pathomechanical Modeling and Clinical Applicationsmentioning

confidence: 99%

Recent Advances in Computational Mechanics of the Human Knee Joint

Kazemi

Dabiri

2013

Computational and Mathematical Methods in Medicine

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“…A note must be reported about the adoption of twodimensional numerical model for the knee. In the literature, different computational models of the knee have been reported; [29][30][31][32][33] however, the mechanical role of IFP has been only recently considered and it has not been deeply studied yet. The choice of the computational model used in this work is made following the information provided by the histological images, that is, the dimensions of septa and adipose chambers in a section of IFP.…”

Section: Discussionmentioning

confidence: 99%

A numerical investigation of the infrapatellar fat pad

Fontanella

Macchi

Porzionato

et al. 2020

Proc Inst Mech Eng H

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The infrapatellar fat pad is an adipose tissue in the knee that facilitates the distribution of synovial fluid and absorbs impulsive actions generated through the joint. The correlation between morphological configuration and mechanical properties is analyzed by a computational approach. The microscopic anatomy of the infrapatellar fat pad is studied aiming to measure the dimension of adipose lobules and the thickness of connective septa. Results from histomorphometric investigations show that the infrapatellar fat pad is an inhomogeneous tissue, constituted by large lobules in the superficial part and smaller lobules in the deepest one. Finite element models of the infrapatellar fat pad are developed. The first model considers the inhomogeneous conformation of the infrapatellar fat pad, composed of micro- and macro-chambers, while the second model considers a homogeneous distribution of adipose lobules with similar dimensions. Computational analyses are performed considering the static standing configuration and the passive flexion–extension movement. The computational results allow us to identify the different stress and strain fields within the tissue and to appreciate the variation of the mechanical performance of the overall system considering the distribution of adipose lobules. Results show that the distribution of adipose lobules in macro- and micro-chambers allows major deformation of the infrapatellar fat pad, decreasing the stress inside the tissues.

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“…Zatímco u kyčle je tlak rozložen rovnoměrně, kongruence je téměř dokonalá, směr pohybu a zatížení z hlediska biomechaniky snadno analyzovatelné a předvídatelné, situaci u kolena komplikuje nestejnoměrné zatížení kontaktních ploch a složitá víceméně individuální biomechanika každého konkrétního kloubu (17), závisející i na stavu vazů, svalového aparátu, mechanické ose kloubu a designu náhrady. Biomechaniku zatěžování kolena v různých situacích lze tak jen obtížně modelovat a propočítat (3,4,7). V minulosti vedly tyto faktory často k selhávání celokeramických náhrad, zejména jejich tibiální komponenty (6,10).…”

Section: Diskuseunclassified

Clinical Evaluation of the Ceramic Femoral Component Used for Reconstruction of Total Knee Replacement

Vavřík¹,

Landor²,

Denk³

2008

ACHOT

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PURPOSE OF THE STUDYThe study evaluates mid-term results of total knee replacement with a zirconia ceramic (ZrO 2 ) femoral component. MATERIALThe evaluated group comprised 20 knees in 19 patients (4 men and 15 women). In one patient the replacement was performed bilaterally. Two patients had in the contralateral knee the same type of prosthesis with a femoral chrome-cobalt component.The mean age at the time of operation was 65.2 years (range, 38-81 years).The primary indication was 14times osteoarthritis and 5times rheumatoid arthritis. The average follow-up period was 6.5 years (range, 2.1-8.5 years). METHODSPatients included in the study regardless of age, body mass and the basic diagnosis, agreed with the use of the ceramic femoral component. The evaluation covered a range of motion, mechanical axis, joint stability, pain, swelling, ability to walk on level ground and on stairs, subjective satisfaction (EULAR Knee Chart). Radiograph were assessed at one year intervals in two projections to identify the incidence of radiolucency around the implant. The Kaplan-Meier survival curve was used and compared with the survival curve in identical chrome-cobalt implants. RESULTSAt he final follow-up, 14 knees were evaluated, because 3 patients died without any connection with the implant, in one case the tibial component migrated due to necrosis of the tibial condyle in a patient with RA and two implants had to be revised and replaced due to polyethylene wear. No infection or negative tissue reaction was recorded in the evaluated group. The average flexion range was 109 degrees. All knees were stable and without swelling, in two cases there occurred slight femoropatellar pain. Twelve patients were fully satisfied, 2 patients were satisfied with a certain reservation. The diferences in the course of the survival curves of chrome-cobalt and ceramic implants were statistically insignificant. DISCUSSIONAlthough the use of zirconia ceramics in vitro reduces the amount of polyethylene wear, the clinical outcomes of total knee replacements as compared to the hip are not convincing. One of the causes may be the substantially different and more complex biomechanics of the knee. Tribology improvement of the femoral ceramic component cannot compensate the deficiencies in the joint balancing in flexion and extension. The economically and technlogically demanding production of these implants may be justified in patients with allergies caused by chrome-cobalt components. CONCLUSIONSThe results of mid-term follow-up of the use of zirconia ceramic femoral components proved no impact on the improvement of the period of survival of the knee implant. No adverse response to the material or mechanical failure of the ceramic components was encountered.

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Numerical modelling of the weight-bearing total knee joint replacement and usage in practice

Cited by 5 publications

References 5 publications

Recent Advances in Computational Mechanics of the Human Knee Joint

Recent Advances in Computational Mechanics of the Human Knee Joint

A numerical investigation of the infrapatellar fat pad

Clinical Evaluation of the Ceramic Femoral Component Used for Reconstruction of Total Knee Replacement

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