Original ArticlesThe importance of tibial alignment: Finite element analysis of tibial malalignment*,**,*
Section snippets
Materials and methods
A three-dimensional finite element model of a proximal right tibia was generated based on a set of serial transverse computed tomography scans of a cadaveric specimen [19]. The tibia was implanted with a flanged-type tibial plateau (Dual Bearing Knee, MMT Ltd, Birmingham, UK) as shown in Fig. 2.The various material properties used in the model are listed in Table 1 [19].Material Modulus (GPa) Poisson Ratio Empty Cell
Results
The stress distribution on the cancellous bone in the different models (varus-valgus angles and posterior angle) is shown in Fig. 4.Regardless of the orientation of the implant, the maximum cancellous bone stresses always appeared in the medial compartment. From 10° of valgus to neutral, the load-bearing
Discussion
The aim of this study was to examine the influence of the orientation of the tibial tray on the cancellous bone stresses because they are believed to relate most closely to migration and aseptic loosening 19, 23, 24, 25. The lowest stress and lowest risk of cancellous bone failure were obtained when the tibial tray was oriented in valgus. According to the tendency observed, the larger this valgus tilt, the lower the stresses within the cancellous bone. In this study, the varus-valgus angle
References (31)
- et al.
Evaluation of tibial component angles in 79 consecutive total knee arthroplasties
Knee
(1999) - et al.
An analysis of tibial component design in total knee arthroplasty
J Biomech
(1983) - et al.
A finite element model for evaluation of tibial prosthesis-bone interface in total knee replacement
J Biomech
(1992) - et al.
Finite element analysis of the implanted proximal tibia: a relationship between the initial cancellous bone stresses and implant migration
J Biomech
(1998) - et al.
Prosthetic reconstruction of the arthritic knee: considerations for limb alignment, geometry of soft tissue reconstruction
Knee
(1998) - et al.
In vivo determination of condylar lift-off and screw-home in a mobile-bearing total knee arthroplasty
J Arthroplasty
(1999) The mechanics of the knee joint in relation to normal walking
J Biomech
(1970)- et al.
Cancellous bone stresses surrounding the femoral component of a hip prosthesis: an elastic-plastic finite element analysis
Med Eng Phys
(1995) - et al.
Epiphyseal-based designs for tibial plateau components. II: stress analysis in the sagittal plane
J Biomech
(1986) - et al.
Epiphyseal-based designs for tibial plateau components. I: stress analysis in the frontal plane
J Biomech
(1986)
Tensile and compressive properties of cancellous bone
J Biomech
Revision total knee arthroplasty
Clin Orthop
Failure in total knee arthroplasty: mechanisms, revisions, and results
Clin Orthop
Freeman-Samuelson total arthroplasty of the knee
Clin Orthop
Revision of total knee arthroplasty
Clin Orthop
Cited by (57)
Micro-CT scan optimisation for mechanical loading of tibia with titanium tibial tray: A digital volume correlation zero strain error analysis
2022, Journal of the Mechanical Behavior of Biomedical MaterialsCitation Excerpt :However, such trays currently have a higher initial failure rate in comparison to their cemented counterparts within the first 2.5–4.0 years post implantation (AOANJRR, 2020), which in some cases may suggest insufficient primary fixation. Computational studies have modelled the immediate post-operative internal strain distribution of tibias implanted with cementless tibial trays (Taylor et al. 1998, 2012; Ryd et al., 1999; Completo et al., 2008; Taylor and Prendergast, 2015; Dawson and Bartel, 1992; Hashemi and Shirazi-Adl, 2000; Perillo-Marcone et al. 2000, 2004; Innocenti et al., 2016; Chong et al., 2011), however, the experimental data published is limited, due to the difficulty in obtaining such measurements directly (Grassi and Isaksson, 2015). Digital volume correlation (DVC) presents a means to measure the internal deformation of bone through time-lapsed micro-computed tomography (micro-CT) image stacks obtained under mechanical load.
The use of computational models in orthopedic biomechanical research
2022, Human Orthopaedic Biomechanics: Fundamentals, Devices and ApplicationsFixed Distal Femoral Cut of 6° Valgus in Total Knee Arthroplasty: A Radiographic Review of 788 Consecutive Cases
2019, Journal of ArthroplastyStandard Radiographs Are Not Sufficient for Assessing Knee Mechanical Axis in Patients With Advanced Osteoarthritis
2017, Journal of ArthroplastyStress shielding in periprosthetic bone following a total knee replacement: Effects of implant material, design and alignment
2016, Medical Engineering and PhysicsCitation Excerpt :Simplified loading conditions were assumed for the cases of malalignment [28] due to the lack of detailed information on the load share distribution of other load cases. Lastly, only the initial post operation strain distributions are reported in present study, whilst long-term effects due to bone remodelling [33,35] are beyond the scope of this work. Evidence has been presented, however, on the positive correlation between the stress/strain distributions immediate post operation and long-term clinical outcome on bone remodelling [38], hence the predictions obtained from this study may be useful for the purpose of bench marking in prosthesis design and clinical decision-making.
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†Department of Orthopaedics, Southampton University Hospital, Southampton, United Kingdom.
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Funds were received from CONICIT and Universidad Simón Bolívar, Venezuela, in support of the research material described in this article.
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Reprint requests: A. Perillo-Marcone, School of Engineering Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK.