Finite element assessment of metaphyseal sleeves in total knee arthroplasty.

This paper investigates the need to use stems in conjunction with cementless metaphyseal sleeves in total knee replacement (TKR) to treat cavity type-3 defects. Finite element models of TKR with type-3 defects of two sizes were modelled with and without stems. The use of sleeves result in stress concentrations at the bone/sleeve interface. The use of stems shows a reduction in these stresses but also an increased risk of bone resorption in the proximal tibia. Based on this investigation the authors recommend that stems are not required in TKR with cementless metaphyseal sleeves. Crown