Yoon Hyuk Kim1, Oh Soo Kwon, Kyungsoo Kim. 1. School of Advanced Technology and Industrial Liaison Research Institute, Kyung Hee University, Republic of Korea. yoonhkim@khu.ac.kr
Abstract
BACKGROUND: The stem-end pain after revision total knee arthroplasty has been clinically reported around the diaphyseal region of the tibia, and the stem-end design has been recognized as one of the causes of the stem-end pain. But there are few reports about the biomechanical characteristics of different stem-end designs on revision total knee arthroplasty. The objective of this study is to investigate the biomechanical effect of the stem-end design in revision total knee arthroplasty. METHODS: Three-dimensional finite element models of a tibia and implants for revision total knee arthroplasty with various stem-end design parameters were developed. The tibia model was chosen from 50 male cadavers to represent the standard Korean male. The contact pressures and von Mises stresses around the stem-end were calculated under axial loading. FINDINGS: The longer stem length, the bigger stem diameter, the stronger press-fit, and no slot shape increased both peak contact pressures and von Mises stresses. The location of peak contact pressures coincided with the location of stem-end pain reported in clinical studies. INTERPRETATION: Different stem-end designs altered the contact pressures or stress concentrations to the tip of the stem. The location of peak contact pressures or von Mises stresses suggested there may be a biomechanical factor to transfer load or generate stress concentration at the location of the stem-end pain in the diaphysis.
BACKGROUND: The stem-end pain after revision total knee arthroplasty has been clinically reported around the diaphyseal region of the tibia, and the stem-end design has been recognized as one of the causes of the stem-end pain. But there are few reports about the biomechanical characteristics of different stem-end designs on revision total knee arthroplasty. The objective of this study is to investigate the biomechanical effect of the stem-end design in revision total knee arthroplasty. METHODS: Three-dimensional finite element models of a tibia and implants for revision total knee arthroplasty with various stem-end design parameters were developed. The tibia model was chosen from 50 male cadavers to represent the standard Korean male. The contact pressures and von Mises stresses around the stem-end were calculated under axial loading. FINDINGS: The longer stem length, the bigger stem diameter, the stronger press-fit, and no slot shape increased both peak contact pressures and von Mises stresses. The location of peak contact pressures coincided with the location of stem-end pain reported in clinical studies. INTERPRETATION: Different stem-end designs altered the contact pressures or stress concentrations to the tip of the stem. The location of peak contact pressures or von Mises stresses suggested there may be a biomechanical factor to transfer load or generate stress concentration at the location of the stem-end pain in the diaphysis.
Authors: J Beckmann; C Lüring; R Springorum; F X Köck; J Grifka; M Tingart Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-09-07 Impact factor: 4.342
Authors: Srinivas C Tadepalli; Kiran H Shivanna; Vincent A Magnotta; Nicole A Kallemeyn; Nicole M Grosland Journal: EURASIP J Adv Signal Process Date: 2010-01-01
Authors: Elisabeth M Sporer; Christoph Schilling; Adrian Sauer; Robert J Tait; Alexander Giurea; Thomas M Grupp Journal: Biomed Res Int Date: 2022-09-12 Impact factor: 3.246