Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
<i>Background and Objectives</i>: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/5/634 |
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| author | Alexandru Cristian Filip Stefan Alexandru Cuculici Stefan Cristea Viviana Filip Alexis Daniel Negrea Simona Mihai Cosmin Marian Pantu |
| author_facet | Alexandru Cristian Filip Stefan Alexandru Cuculici Stefan Cristea Viviana Filip Alexis Daniel Negrea Simona Mihai Cosmin Marian Pantu |
| author_sort | Alexandru Cristian Filip |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration offering sufficient stability and good long-term survivorship. The following question arises: which situation requires the use of a standard configuration implant (without a stem) and which situation requires using the extension? <i>Materials and Methods</i>: The opportunity to use the tibial extension in the primary TKA was analyzed in correlation to the tibial bone structural properties. Using finite elements (FEs), the virtual model of the tibial bone was connected to that of the prosthetic implant, with and without a stem, and its behavior was analyzed during static and dynamic stresses, both in the situation in which the bone had normal physical properties, as well as in the case in which the bone had diminished physical properties. <i>Results:</i> The maximum stress and displacement values in the static compression regime show that adding a stem is only beneficial to structurally altered bone. Compression fatigue was reduced to almost half in the case of altered bone when adding a stem. Dynamic compression showed slightly better results with the tibial stem in both healthy and degraded bone. <i>Conclusions</i>: It was concluded that, if the bone is healthy and has good structural properties, it is not necessary to use the tibial extension in the primary operation; and if the bone has diminished physical properties, it is necessary to use the tibial extension at the primary operation, enhancing the stability, fixation, and implant lifespan. |
| first_indexed | 2024-03-10T03:28:19Z |
| format | Article |
| id | doaj.art-c65cac41a0634e06b44efb539a695934 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T03:28:19Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-c65cac41a0634e06b44efb539a6959342023-11-23T12:03:42ZengMDPI AGMedicina1010-660X1648-91442022-05-0158563410.3390/medicina58050634Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone PropertiesAlexandru Cristian Filip0Stefan Alexandru Cuculici1Stefan Cristea2Viviana Filip3Alexis Daniel Negrea4Simona Mihai5Cosmin Marian Pantu6Radiology and Medical Imaging Department, ‘Dr. Carol Davila’ Central University Emergency Military Hospital, 010825 Bucharest, RomaniaDepartment of Orthopedic Surgery, Ilfov County Emergency Clinical Hospital, 022104 Bucharest, RomaniaDepartment of Orthopedic Surgery and Trauma, ‘Sf. Pantelimon’ Emergency Clinical Hospital, 021659 Bucharest, RomaniaMechanical Department, Doctoral School, ‘Valahia’ University, 130004 Targoviste, RomaniaMechanical Department, Materials and Mechanical Faculty, ‘Valahia’ University, 130004 Targoviste, RomaniaMechanical Department, Institute of Multidisciplinary Research for Science and Technology, ‘Valahia’ University, 130004 Targoviste, RomaniaDepartment 2—Morphological Sciences—Anatomy, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania<i>Background and Objectives</i>: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration offering sufficient stability and good long-term survivorship. The following question arises: which situation requires the use of a standard configuration implant (without a stem) and which situation requires using the extension? <i>Materials and Methods</i>: The opportunity to use the tibial extension in the primary TKA was analyzed in correlation to the tibial bone structural properties. Using finite elements (FEs), the virtual model of the tibial bone was connected to that of the prosthetic implant, with and without a stem, and its behavior was analyzed during static and dynamic stresses, both in the situation in which the bone had normal physical properties, as well as in the case in which the bone had diminished physical properties. <i>Results:</i> The maximum stress and displacement values in the static compression regime show that adding a stem is only beneficial to structurally altered bone. Compression fatigue was reduced to almost half in the case of altered bone when adding a stem. Dynamic compression showed slightly better results with the tibial stem in both healthy and degraded bone. <i>Conclusions</i>: It was concluded that, if the bone is healthy and has good structural properties, it is not necessary to use the tibial extension in the primary operation; and if the bone has diminished physical properties, it is necessary to use the tibial extension at the primary operation, enhancing the stability, fixation, and implant lifespan.https://www.mdpi.com/1648-9144/58/5/634total knee arthroplastyprimary total knee arthroplastyimplantprosthesistibial stem extensionosteoarthritis |
| spellingShingle | Alexandru Cristian Filip Stefan Alexandru Cuculici Stefan Cristea Viviana Filip Alexis Daniel Negrea Simona Mihai Cosmin Marian Pantu Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties Medicina total knee arthroplasty primary total knee arthroplasty implant prosthesis tibial stem extension osteoarthritis |
| title | Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties |
| title_full | Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties |
| title_fullStr | Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties |
| title_full_unstemmed | Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties |
| title_short | Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties |
| title_sort | tibial stem extension versus standard configuration in total knee arthroplasty a biomechanical assessment according to bone properties |
| topic | total knee arthroplasty primary total knee arthroplasty implant prosthesis tibial stem extension osteoarthritis |
| url | https://www.mdpi.com/1648-9144/58/5/634 |
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