Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding
Aims: This study aimed to identify the effect of anatomical tibial component (ATC) design on load distribution in the periprosthetic tibial bone of Koreans using finite element analysis (FEA). Methods: 3D finite element models of 30 tibiae in Korean women were created. A symmetric tibial component (...
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2022-05-01
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| Series: | Bone & Joint Research |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.115.BJR-2021-0537.R1 |
| _version_ | 1818488909339820032 |
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| author | Byung W. Cho Kyoung-Tak Kang Hyuck M. Kwon Woo-Suk Lee Ick H. Yang Ji H. Nam Yong-Gon Koh Kwan K. Park |
| author_facet | Byung W. Cho Kyoung-Tak Kang Hyuck M. Kwon Woo-Suk Lee Ick H. Yang Ji H. Nam Yong-Gon Koh Kwan K. Park |
| author_sort | Byung W. Cho |
| collection | DOAJ |
| description | Aims: This study aimed to identify the effect of anatomical tibial component (ATC) design on load distribution in the periprosthetic tibial bone of Koreans using finite element analysis (FEA). Methods: 3D finite element models of 30 tibiae in Korean women were created. A symmetric tibial component (STC, NexGen LPS-Flex) and an ATC (Persona) were used in surgical simulation. We compared the FEA measurements (von Mises stress and principal strains) around the stem tip and in the medial half of the proximal tibial bone, as well as the distance from the distal stem tip to the shortest anteromedial cortical bone. Correlations between this distance and FEA measurements were then analyzed. Results: The distance from the distal stem tip to the shortest cortical bone showed no statistically significant difference between implants. However, the peak von Mises stress around the distal stem tip was higher with STC than with ATC. In the medial half of the proximal tibial bone: 1) the mean von Mises stress, maximum principal strain, and minimum principal strain were higher with ATC; 2) ATC showed a positive correlation between the distance and mean von Mises stress; 3) ATC showed a negative correlation between the distance and mean minimum principal strain; and 4) STC showed no correlation between the distance and mean measurements. Conclusion: Implant design affects the load distribution on the periprosthetic tibial bone, and ATC can be more advantageous in preventing stress-shielding than STC. However, under certain circumstances with short distances, the advantage of ATC may be offset. Cite this article: Bone Joint Res 2022;11(5):252–259. |
| first_indexed | 2024-12-10T16:57:09Z |
| format | Article |
| id | doaj.art-865b49a76c4a4ad0977038a991bda320 |
| institution | Directory Open Access Journal |
| issn | 2046-3758 |
| language | English |
| last_indexed | 2024-12-10T16:57:09Z |
| publishDate | 2022-05-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Research |
| spelling | doaj.art-865b49a76c4a4ad0977038a991bda3202022-12-22T01:40:41ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582022-05-0111525225910.1302/2046-3758.115.BJR-2021-0537.R1Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shieldingByung W. Cho0Kyoung-Tak Kang1Hyuck M. Kwon2Woo-Suk Lee3Ick H. Yang4Ji H. Nam5Yong-Gon Koh6Kwan K. Park7Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Mechanical Engineering, Yonsei University, Seoul, South KoreaDepartment of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Mechanical Engineering, Yonsei University, Seoul, South KoreaJoint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, South KoreaDepartment of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaAims: This study aimed to identify the effect of anatomical tibial component (ATC) design on load distribution in the periprosthetic tibial bone of Koreans using finite element analysis (FEA). Methods: 3D finite element models of 30 tibiae in Korean women were created. A symmetric tibial component (STC, NexGen LPS-Flex) and an ATC (Persona) were used in surgical simulation. We compared the FEA measurements (von Mises stress and principal strains) around the stem tip and in the medial half of the proximal tibial bone, as well as the distance from the distal stem tip to the shortest anteromedial cortical bone. Correlations between this distance and FEA measurements were then analyzed. Results: The distance from the distal stem tip to the shortest cortical bone showed no statistically significant difference between implants. However, the peak von Mises stress around the distal stem tip was higher with STC than with ATC. In the medial half of the proximal tibial bone: 1) the mean von Mises stress, maximum principal strain, and minimum principal strain were higher with ATC; 2) ATC showed a positive correlation between the distance and mean von Mises stress; 3) ATC showed a negative correlation between the distance and mean minimum principal strain; and 4) STC showed no correlation between the distance and mean measurements. Conclusion: Implant design affects the load distribution on the periprosthetic tibial bone, and ATC can be more advantageous in preventing stress-shielding than STC. However, under certain circumstances with short distances, the advantage of ATC may be offset. Cite this article: Bone Joint Res 2022;11(5):252–259.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.115.BJR-2021-0537.R1total knee arthroplastyfinite element analysisanatomical tibial componentstress-shieldingmedial proximal tibial bone lossanatomical tibial componenttibial bonetotal knee arthroplasty (tka)tibial componentscortical bonestrainsfinite element modelsfinite element analysispearson correlationcancellous bone |
| spellingShingle | Byung W. Cho Kyoung-Tak Kang Hyuck M. Kwon Woo-Suk Lee Ick H. Yang Ji H. Nam Yong-Gon Koh Kwan K. Park Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding Bone & Joint Research total knee arthroplasty finite element analysis anatomical tibial component stress-shielding medial proximal tibial bone loss anatomical tibial component tibial bone total knee arthroplasty (tka) tibial components cortical bone strains finite element models finite element analysis pearson correlation cancellous bone |
| title | Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding |
| title_full | Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding |
| title_fullStr | Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding |
| title_full_unstemmed | Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding |
| title_short | Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty: finite element analysis indicating anatomical design prevents stress-shielding |
| title_sort | biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty finite element analysis indicating anatomical design prevents stress shielding |
| topic | total knee arthroplasty finite element analysis anatomical tibial component stress-shielding medial proximal tibial bone loss anatomical tibial component tibial bone total knee arthroplasty (tka) tibial components cortical bone strains finite element models finite element analysis pearson correlation cancellous bone |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.115.BJR-2021-0537.R1 |
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