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Research Papers

Analysis of an Early Intervention Tibial Component for Medial Osteoarthritis

[+] Author and Article Information
M. E. Chaudhary

Department of Orthopaedic Surgery,
NYU Hospital for Joint Diseases,
301 East 17th Street, Suite 1500,
New York, NY 10003;
Department of Chemical and
Biomolecular Engineering,
NYU Polytechnic School of Engineering,
Brooklyn, NY 11201
e-mail: mc3391@nyu.edu

P. S. Walker

Department of Orthopaedic Surgery,
NYU Hospital for Joint Diseases,
New York, NY
Department of Mechanical and
Aerospace Engineering,
NYU Polytechnic School of Engineering,
Brooklyn, NY 11201

1Corresponding author.

Manuscript received August 20, 2013; final manuscript received April 5, 2014; accepted manuscript posted April 22, 2014; published online May 7, 2014. Assoc. Editor: Paul Rullkoetter.

J Biomech Eng 136(6), 061008 (May 07, 2014) (5 pages) Paper No: BIO-13-1379; doi: 10.1115/1.4027467 History: Received August 20, 2013; Revised April 05, 2014; Accepted April 22, 2014

Tibial component loosening is an important failure mode in unicompartmental knee arthroplasty (UKA) which may be due to the 6–8 mm of bone resection required. To address component loosening and fixation, a new early intervention (EI) design is proposed which reverses the traditional material scheme between femoral and tibial components. The EI design consists of a plastic inlay for the distal femur and a thin metal plate for the proximal tibia. With this reversed materials scheme, the EI design requires minimal tibial bone resection compared with traditional UKA. This study investigated, by means of finite element (FE) simulations, the advantages of a thin metal tibial component compared with traditional UKA tibial components, such as an all-plastic inlay or a metal-backed onlay. We hypothesized that an EI tibial component would produce comparable stress, strain, and strain energy density (SED) characteristics to an intact knee and more favorable values than UKA components, due primarily to the preservation of dense cancellous bone near the surface. Indeed, FE results showed that stresses in the supporting bone for an EI design were close to intact, while stresses, strains, and strain energy densities were reduced compared with an all-plastic UKA component. Analyzed parameters were similar for an EI and a metal-backed onlay, but the EI component had the advantage of minimal resection of the stiffest bone.

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Figures

Grahic Jump Location
Fig. 1

(a) Five components analyzed: EI 2 mm, EI 2 mm with keel, EI 3 mm, all-plastic UKA, metal-backed UKA. (b) Change in bone density (kg/m3) and elastic modulus (MPa) with resection depths ranging from 2 mm to 8 mm.

Grahic Jump Location
Fig. 2

(a) Maximum von Mises stresses for center and offset loading in the anterior–posterior direction. (b) Contour plots of von Mises stresses at the bone interface for cemented components centrally loaded.

Grahic Jump Location
Fig. 3

(a) Maximum and minimum principal strains for center and offset loading in the anterior–posterior direction. (b) Contour plots of maximum and minimum principal strains at the bone interface for cemented components centrally loaded.

Grahic Jump Location
Fig. 4

(a) Maximum strain energy densities for center and offset loading in the anterior–posterior direction. (b) Contour plots of strain energy densities within the bone for cemented components centrally loaded.

Grahic Jump Location
Fig. 5

Contour plots of stresses and strains at the bone interface surface of an EI 3 mm component and EI 2 mm component with keel design

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