Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study
The purposes of this study were to develop a cruciate-retaining total knee arthroplasty musculoskeletal model, which enables the adjustment of ligament length and implant alignment; validate the model; and evaluate the effects of varus/valgus alignment adjustment and unbalanced medial/lateral ligame...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.851495/full |
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| author | Jaehun Ro Du Hyun Ro Du Hyun Ro Yeokyung Kang Yeokyung Kang Hyuk-Soo Han Choongsoo S. Shin |
| author_facet | Jaehun Ro Du Hyun Ro Du Hyun Ro Yeokyung Kang Yeokyung Kang Hyuk-Soo Han Choongsoo S. Shin |
| author_sort | Jaehun Ro |
| collection | DOAJ |
| description | The purposes of this study were to develop a cruciate-retaining total knee arthroplasty musculoskeletal model, which enables the adjustment of ligament length and implant alignment; validate the model; and evaluate the effects of varus/valgus alignment adjustment and unbalanced medial/lateral ligament laxity during gait. A cruciate-retaining total knee arthroplasty musculoskeletal model was constructed and validated against the in vivo contact forces. This model was transformed to 2° varus/valgus alignment of femoral or tibial replacement models and 2° medial/lateral laxity models. The contact forces and ligament tensions of the adjusted models were calculated. The contact forces in the model showed good agreement with the in vivo contact forces. Valgus replacement alignment with balanced ligament models showed a lower contact force at the medial compartment than at the neutral alignment model, whereas the varus replacement alignment with balanced ligament models showed a greater contact force at the medial compartment and medial/posterior cruciate ligament tension. The medial laxity with neutral alignment model showed a similar contact force with decreased medial ligament tension compared to the balanced neutral alignment model, whereas the lateral laxity with the neutral alignment model showed a greater contact force and decreased lateral ligament tension. The cruciate-retaining total knee arthroplasty model was validated using in vivo contact forces (r = 0.939) Two degrees of valgus alignment adjustment with balanced ligament or neutral alignment with 2° of medial laxity can be safe without increasing contact force or ligament tension compared to neutral alignment with a balanced extension gap. However, 2° of varus alignment adjustment with balanced ligament or neutral alignment with 2° of lateral laxity may be unfavorable due to the overloading of the joints and knee ligaments. |
| first_indexed | 2024-04-13T04:24:20Z |
| format | Article |
| id | doaj.art-cbe7ee1b34fe4a7290714be11e9fc21c |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-13T04:24:20Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-cbe7ee1b34fe4a7290714be11e9fc21c2022-12-22T03:02:35ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-04-011010.3389/fbioe.2022.851495851495Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation StudyJaehun Ro0Du Hyun Ro1Du Hyun Ro2Yeokyung Kang3Yeokyung Kang4Hyuk-Soo Han5Choongsoo S. Shin6Central R&D Center, Corentec Co., Ltd., Seoul, KoreaDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, KoreaCONNECTEVE Co., Ltd, Seoul, KoreaCentral R&D Center, Corentec Co., Ltd., Seoul, KoreaDepartment of Biomedical Engineering, Yonsei University, Seoul, KoreaDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, KoreaDepartment of Mechanical Engineering, Sogang University, Seoul, KoreaThe purposes of this study were to develop a cruciate-retaining total knee arthroplasty musculoskeletal model, which enables the adjustment of ligament length and implant alignment; validate the model; and evaluate the effects of varus/valgus alignment adjustment and unbalanced medial/lateral ligament laxity during gait. A cruciate-retaining total knee arthroplasty musculoskeletal model was constructed and validated against the in vivo contact forces. This model was transformed to 2° varus/valgus alignment of femoral or tibial replacement models and 2° medial/lateral laxity models. The contact forces and ligament tensions of the adjusted models were calculated. The contact forces in the model showed good agreement with the in vivo contact forces. Valgus replacement alignment with balanced ligament models showed a lower contact force at the medial compartment than at the neutral alignment model, whereas the varus replacement alignment with balanced ligament models showed a greater contact force at the medial compartment and medial/posterior cruciate ligament tension. The medial laxity with neutral alignment model showed a similar contact force with decreased medial ligament tension compared to the balanced neutral alignment model, whereas the lateral laxity with the neutral alignment model showed a greater contact force and decreased lateral ligament tension. The cruciate-retaining total knee arthroplasty model was validated using in vivo contact forces (r = 0.939) Two degrees of valgus alignment adjustment with balanced ligament or neutral alignment with 2° of medial laxity can be safe without increasing contact force or ligament tension compared to neutral alignment with a balanced extension gap. However, 2° of varus alignment adjustment with balanced ligament or neutral alignment with 2° of lateral laxity may be unfavorable due to the overloading of the joints and knee ligaments.https://www.frontiersin.org/articles/10.3389/fbioe.2022.851495/fullknee arthroplastymodelcoronal alignmentcollateral ligament tensioncontact force |
| spellingShingle | Jaehun Ro Du Hyun Ro Du Hyun Ro Yeokyung Kang Yeokyung Kang Hyuk-Soo Han Choongsoo S. Shin Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study Frontiers in Bioengineering and Biotechnology knee arthroplasty model coronal alignment collateral ligament tension contact force |
| title | Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study |
| title_full | Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study |
| title_fullStr | Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study |
| title_full_unstemmed | Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study |
| title_short | Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study |
| title_sort | biomechanical effect of coronal alignment and ligament laxity in total knee arthroplasty a simulation study |
| topic | knee arthroplasty model coronal alignment collateral ligament tension contact force |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.851495/full |
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