Biomechanical optimization scheme of artificial ankle inserts based on porous structure design

doi:10.12307/2024.644

Abstract

Abstract: BACKGROUND: Prosthesis loosening and wear are still the main problems in the failure of total ankle replacement, which are closely related to the micro-motion of the implant-bone interface, the contact stress of the articular surface and joint motion. The design of artificial joint components, including insert and tibial/talar stem prosthesis, is a key factor affecting the force, motion, and micromotion of the contact interface of the ankle joint. The development of new inserts is of great significance to improve the survival rate of artificial ankle joints.
OBJECTIVE: The finite element model of the total ankle replacement model was constructed to detect the biomechanical properties of the porous structure-optimized inserts, and the effect of the porous structure-optimized inserts on reducing prosthesis micromotion and improving the contact behavior of the articular surface was analyzed.
METHODS: Based on the CT scan data of the right ankle joint of a healthy adult and the INBONE II system product manual, a three-dimensional model including bone and artificial joint system was established, and the total ankle replacement model (model A) was obtained after osteotomy and prosthesis installation, and then through four new types of inserts, G50, G60, D50, and D60, were obtained by transforming the porous structure of the original insert, and the original one was replaced with different inserts to establish an optimized total ankle replacement model (models B-E) corresponding to the inserts. The gait loads were applied on the five models to simulate the gait conditions. The differences in micromotion and articular surface contact behaviors at the implant-bone interface of all five models were compared.
RESULTS AND CONCLUSION: (1) In the gait cycle, the micromotion of the prosthesis of the four optimized total ankle replacement models was lower than that of the original model. Compared with model A, the micromotion of the prosthesis in models B-E decreased by 5.4%, 10.1%, 8.1%, and 20.9%, respectively. The high micromotion area of the tibial groove dome in the optimized model was significantly smaller than that of the original model. (2) The four optimized models obtained a larger articular surface contact area. Compared with model A, the average contact area of the inserts in models B-E increased by 11.8%, 14.7%, 8.1%, and 32.6%, respectively. (3) Similar to the effect of increasing the contact area, compared with the original model, the contact stress of the optimized model decreased in varying degrees, and the value of model E decreased the most significantly (P < 0.05), it is due to good mechanical properties and large porosity of the Diamond lattice that constitutes the D60-type insert. (4) The research results show that the use of porous structure to improve the inserts can improve the elasticity of the inserts and increase its ability to absorb joint impact, for favorable conditions are created for reducing micromotion at the implant-bone interface and improving joint contact behavior.

Key words: total ankle replacement, artificial ankle, insert, porous structure, finite element analysis

CLC Number:

Xu Zhi, Liu Ziming, Li Yuwan, , Chen Yufei, Jin Ying, Rao Jingcheng, Tian Shoujin. Biomechanical optimization scheme of artificial ankle inserts based on porous structure design[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(30): 4817-4824.

Figures/Tables 3

2.3 各模型关节面接触面积比较图5c显示了不同模型在步态周期下衬垫接触面积变化趋势，在支撑相伴随着轴向载荷增加，衬垫的接触面积逐渐增大并在50%时刻达到峰值，随着进入摆动相轴向载荷减少，衬垫接触面积逐渐下降趋于稳定。与模型A衬垫接触面积均值相比，模型B-E均值分别增加11.8%，14.7%，8.1%及32.6%，见表5。与衬垫接触面积变化趋势类似，各距骨假体接触面积在支撑相后期达到峰值，见图5d。与模型A距骨假体接触面积均值相比，模型B-E均值分别增加10.9%，25.5%，10.8%，37.5%，见表5。可见模型E在关节面两侧的接触面积增加最为明显。 2.4 各模型关节面接触应力比较 5个模型衬垫最大接触应力随着在支撑相轴向载荷增加而增加，在步态周期的50%时刻达到峰值，随后进入摆动相后分别在4-10 MPa的区间保持稳定，见图5e。与模型A衬垫最大接触应力均值相比，模型B-E均值分别降低10.1%，8.2%，0.9%及20.3%，见表5。图7展示了衬垫在50%时刻受力的应力云图，可见模型A的高应力区集中有2处，一处在外侧关节面后部，一处位于内外关节面移行部，令人感到欣慰的是，4个优化模型在该两处的高应力区域面积不同程度减少，模型E外侧关节面的高应力区域消失，仅剩的高应力区域仅散在分布在关节面移行部。图5f展示了各模型距骨假体关节面最大接触应力走势，可见各模型应力变化在形式上更加丰富，在大体上保持了在支撑相升高并在摆动相下降的总体规律。定量化分析结果得出模型B距骨假体接触应力均值分别较模型A、C、D降低37.5%，37.4%及32.5%；模型E距骨假体接触应力均值分别较模型A、C、D降低49.1%，49.0%及45.0%，见表5。与衬垫应力云图展示效果相似，优化模型(模型B-E)距骨假体关节面高应力区域较原始模型(模型A)明显减少，低应力区域分布更加均匀。"

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