Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees
Aims: Unicompartmental knee arthroplasty (UKA) has become a popular method of treating knee localized osteoarthritis (OA). Additionally, the posterior cruciate ligament (PCL) is essential to maintaining the physiological kinematics and functions of the knee joint. Considering these factors, the purp...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The British Editorial Society of Bone & Joint Surgery
2020-09-01
|
| Series: | Bone & Joint Research |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.99.BJR-2020-0128.R1 |
| _version_ | 1818989319815168000 |
|---|---|
| author | Jin-Ah Lee Yong-Gon Koh Paul Shinil Kim Ki Won Kang Yoon Hae Kwak Kyoung-Tak Kang |
| author_facet | Jin-Ah Lee Yong-Gon Koh Paul Shinil Kim Ki Won Kang Yoon Hae Kwak Kyoung-Tak Kang |
| author_sort | Jin-Ah Lee |
| collection | DOAJ |
| description | Aims: Unicompartmental knee arthroplasty (UKA) has become a popular method of treating knee localized osteoarthritis (OA). Additionally, the posterior cruciate ligament (PCL) is essential to maintaining the physiological kinematics and functions of the knee joint. Considering these factors, the purpose of this study was to investigate the biomechanical effects on PCL-deficient knees in medial UKA. Methods: Computational simulations of five subject-specific models were performed for intact and PCL-deficient UKA with tibial slopes. Anteroposterior (AP) kinematics and contact stresses of the patellofemoral (PF) joint and the articular cartilage were evaluated under the deep-knee-bend condition. Results: As compared to intact UKA, there was no significant difference in AP translation in PCL-deficient UKA with a low flexion angle, but AP translation significantly increased in the PCL-deficient UKA with high flexion angles. Additionally, the increased AP translation became decreased as the posterior tibial slope increased. The contact stress in the PF joint and the articular cartilage significantly increased in the PCL-deficient UKA, as compared to the intact UKA. Additionally, the increased posterior tibial slope resulted in a significant decrease in the contact stress on PF joint but significantly increased the contact stresses on the articular cartilage. Conclusion: Our results showed that the posterior stability for low flexion activities in PCL-deficient UKA remained unaffected; however, the posterior stability for high flexion activities was affected. This indicates that a functional PCL is required to ensure normal stability in UKA. Additionally, posterior stability and PF joint may reduce the overall risk of progressive OA by increasing the posterior tibial slope. However, the excessive posterior tibial slope must be avoided. |
| first_indexed | 2024-12-20T19:36:36Z |
| format | Article |
| id | doaj.art-c28b8adb25cc4391a2581251a040c5e8 |
| institution | Directory Open Access Journal |
| issn | 2046-3758 |
| language | English |
| last_indexed | 2024-12-20T19:36:36Z |
| publishDate | 2020-09-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Research |
| spelling | doaj.art-c28b8adb25cc4391a2581251a040c5e82022-12-21T19:28:38ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582020-09-019959360010.1302/2046-3758.99.BJR-2020-0128.R1Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient kneesJin-Ah Lee0Yong-Gon Koh1Paul Shinil Kim2Ki Won Kang3Yoon Hae Kwak4Kyoung-Tak Kang5Department of Mechanical Engineering, Yonsei University, Seoul, South KoreaJoint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, South KoreaDepartment of Orthopaedic Surgery, The Bone Hospital, Seoul, South KoreaGaja Yonsei Orthopaedic Clinic, Incheon, South KoreaDepartment of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Mechanical Engineering, Yonsei University, Seoul, South KoreaAims: Unicompartmental knee arthroplasty (UKA) has become a popular method of treating knee localized osteoarthritis (OA). Additionally, the posterior cruciate ligament (PCL) is essential to maintaining the physiological kinematics and functions of the knee joint. Considering these factors, the purpose of this study was to investigate the biomechanical effects on PCL-deficient knees in medial UKA. Methods: Computational simulations of five subject-specific models were performed for intact and PCL-deficient UKA with tibial slopes. Anteroposterior (AP) kinematics and contact stresses of the patellofemoral (PF) joint and the articular cartilage were evaluated under the deep-knee-bend condition. Results: As compared to intact UKA, there was no significant difference in AP translation in PCL-deficient UKA with a low flexion angle, but AP translation significantly increased in the PCL-deficient UKA with high flexion angles. Additionally, the increased AP translation became decreased as the posterior tibial slope increased. The contact stress in the PF joint and the articular cartilage significantly increased in the PCL-deficient UKA, as compared to the intact UKA. Additionally, the increased posterior tibial slope resulted in a significant decrease in the contact stress on PF joint but significantly increased the contact stresses on the articular cartilage. Conclusion: Our results showed that the posterior stability for low flexion activities in PCL-deficient UKA remained unaffected; however, the posterior stability for high flexion activities was affected. This indicates that a functional PCL is required to ensure normal stability in UKA. Additionally, posterior stability and PF joint may reduce the overall risk of progressive OA by increasing the posterior tibial slope. However, the excessive posterior tibial slope must be avoided.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.99.BJR-2020-0128.R1unicompartmental knee arthroplastyposterior cruciate ligamenttibial slopefinite element method |
| spellingShingle | Jin-Ah Lee Yong-Gon Koh Paul Shinil Kim Ki Won Kang Yoon Hae Kwak Kyoung-Tak Kang Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees Bone & Joint Research unicompartmental knee arthroplasty posterior cruciate ligament tibial slope finite element method |
| title | Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees |
| title_full | Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees |
| title_fullStr | Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees |
| title_full_unstemmed | Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees |
| title_short | Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees |
| title_sort | biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament deficient knees |
| topic | unicompartmental knee arthroplasty posterior cruciate ligament tibial slope finite element method |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.99.BJR-2020-0128.R1 |
| work_keys_str_mv | AT jinahlee biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees AT yonggonkoh biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees AT paulshinilkim biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees AT kiwonkang biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees AT yoonhaekwak biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees AT kyoungtakkang biomechanicaleffectoftibialslopeonthestabilityofmedialunicompartmentalkneearthroplastyinposteriorcruciateligamentdeficientknees |