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Research Papers

A Finite-Element Study of Metal Backing and Tibial Resection Depth in a Composite Tibia Following Total Knee Arthroplasty

[+] Author and Article Information
Susumu Tokunaga

Rose-Hulman Institute of Technology,
5500 Wabash Avenue,
Terre Haute, IN 47803
e-mail: stokunaga@hotmail.com

Renee D. Rogge

Rose-Hulman Institute of Technology,
5500 Wabash Avenue,
Terre Haute, IN 47803
e-mail: rogge@rose-hulman.edu

Scott R. Small

JRSI Foundation, Inc.,
1199 Hadley Road,
Mooresville, IN 46158
e-mail: scott.small@rose-hulman.edu

Michael E. Berend

JRSI Foundation, Inc.,
1199 Hadley Road,
Mooresville, IN 46158
e-mail: mikeberend@me.com

Merrill A. Ritter

JRSI Foundation, Inc.,
1199 Hadley Road,
Mooresville, IN 46158
e-mail: marittermd@mindspring.com

1Corresponding author.

Manuscript received July 15, 2015; final manuscript received January 1, 2016; published online February 12, 2016. Assoc. Editor: Joel D. Stitzel.

J Biomech Eng 138(4), 041001 (Feb 12, 2016) (8 pages) Paper No: BIO-15-1349; doi: 10.1115/1.4032551 History: Received July 15, 2015; Revised January 01, 2016

Prosthetic alignment, patient characteristics, and implant design are all factors in long-term survival of total knee arthroplasty (TKA), yet the level at which each of these factors contribute to implant loosening has not been fully described. Prior clinical and biomechanical studies have indicated tibial overload as a cause of early TKA revision. The purpose of this study was to determine the relationship between tibial component design and bone resection on tibial loading. Finite-element analysis (FEA) was performed after simulated implantation of metal backed (MB) and all-polyethylene (AP) TKA components in 5 and 15 mm of tibial resection into a validated intact tibia model. Proximal tibial strains significantly increased between 13% and 199% when implanted with AP components (p < 0.05). Strain significantly increased between 12% and 209% in the posterior tibial compartment with increased bone resection (p < 0.05). This study indicates elevated strains in AP implanted tibias across the entirety of the proximal tibial cortex, as well as a posterior shift in tibial loading in instances of increased resection depth. These results are consistent with trends observed in prior biomechanical studies and may associate the documented device history of tibial collapse in AP components with increased bone strain and overload beneath the prosthesis.

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References

Figures

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Fig. 1

Strain gage measurement locations for (top) axial compression validation testing and (bottom) three-point bending validation tests. Strain gage locations were selected to be generally consistent with prior published literature [1719]. FE boundary conditions were set consistently with biomechanical testing, with FE strain probes located at the strain gage locations within the model for comparison between FE and experimental results.

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Fig. 2

Contact area verification in the 05-AP model comparing (left) modeled (right) experimental contact regions as characterized with a high contrast dye transferred from the femoral component onto the tibial tray

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Fig. 3

Measurement regions as defined in prior biomechanical photoelastic studies [11,12,22,23]. These regions were utilized for derivation of loading trends in general proximal tibial areas. AMP: anteromedial peripheral, AMC: anteromedial central, ALC: anterolateral central, ALP: anterolateral peripheral, PLP: posterolateral peripheral, PLC: posterolateral central, PMC: posteromedial central, and PMP: posteromedial peripheral.

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Fig. 4

Experimental and FE minimum and maximum principal strains (με) measured for thethree-point bending (top) and axial compression (bottom) validation tests at each of the designated strain gage measurement regions

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Fig. 5

Least-squares mean maximum shear strains measured at the 24 regions based on 20 measurements under 50:50 (top) and 80:20 (bottom) mediolateral loading distributions. Measurements are divided by measurement regions 0–1 cm, 1–2 cm, and 2–3 cm distal to the tibial plateau.

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