Biomechanical effects of different placement of femoral prosthesis in unicompartmental knee arthroplasty

doi:10.12307/2022.505

Abstract

Abstract: BACKGROUND: Most of the revision causes of unicompartmental knee arthroplasty are postoperative complications, such as prosthesis loosening, polyethylene wear and progression of uninvolved compartment arthritis, which are linked to the abnormal intra-articular stress caused by the malposition of the prosthesis.
OBJECTIVE: To study the effects of different positions of the femoral prosthesis on the stress magnitude and distribution of polyethylene surface, articular cartilage surface, and cancellous bone surface during unicompartmental knee arthroplasty.
METHODS: The digital image of the knee joint and prosthesis was obtained using radiological technologies and three-dimensional scanning techniques. A normal knee model was developed and validated using mimics and Ansys workbench software. Unicompartmental knee arthroplasty was simulated in Ansys Workbench software. The prosthesis was positioned appropriately and the femoral prosthesis was requisitioned. Nine working conditions were established at the 0°, 3°, 6°, 9°, and 12° of femoral prosthesis varus and valgus to observe the changes in stress and distribution of polyethylene surface, articular cartilage surface and cancellous bone surface in each model.
RESULTS AND CONCLUSION: (1) The stress on the upper surface of polyethylene increased with the increase of the valgus and varus angle in the prosthesis under static load of knee joint extension, and the increase range was large during valgus. The stress distribution on the upper surface of polyethylene shifts was inward during varus and outward during valgus. (2) The stress on the articular cartilage surface increased during varus and decreased during valgus. (3) The stress on the surface of cancellous bone was concentrated in the grooves, and the stress was increased during valgus and varus, and greater during valgus. (4) As move from varus to valgus, the load shifted to the medial side of the knee. (5) Among all the structures, the stress on the upper surface of polyethylene prosthesis was the highest, and the stress value at ≥6° of valgus and valgus of femoral prosthesis was significantly higher than that at the standard position (0° valgus and valgus).

Key words: knee, arthroplasty, unicompartmental knee arthroplasty, prosthesis fitting, biomechanics, stress, finite element analysis

CLC Number:

Ma Pengcheng, Zhang Siping, Sun Rongxin, Chai Hao, Jiang Kan. Biomechanical effects of different placement of femoral prosthesis in unicompartmental knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(12): 1843-1848.

Figures/Tables 5

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