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Medial unicompartmental knee arthroplasty to patients with a ligamentous deficiency can cause biomechanically poor outcomes

Authors
 Hyuck Min Kwon  ;  Kyoung-Tak Kang  ;  Jung Hwan Kim  ;  Kwan Kyu Park 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.28(9) : 2846-2853, 2020-09 
Journal Title
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 
ISSN
 0942-2056 
Issue Date
2020-09
Keywords
Contact stress ; Finite-element analysis ; Ligament ; Medial unicompartmental knee arthroplasty ; Unicompartmental knee replacement
Abstract
Purpose: The aims of this study were to investigate the biomechanical effects of the deficiency of the collateral ligament and cruciate ligament in medial unicompartmental knee arthroplasty in normal and varus knee patients using computational simulation. Methods: Validated finite-element (FE) models for conditions of various cruciate and collateral ligament deficiencies were developed to evaluate the biomechanical effects of ligamentous deficiency in UKA for normal and varus knee patients. Contact stresses on the polyethylene (PE) insert, contact stresses on the lateral articular cartilage, and quadriceps force were analyzed under gait-loading conditions. Results: Contact stresses on the PE insert and lateral articular cartilage as well as quadriceps force in a normal knee UKA FE model were increased in the order of anterior cruciate ligament (ACL) deficiency, medial collateral ligament (MCL) deficiency, lateral collateral ligament (LCL) deficiency, and posterior cruciate ligament (PCL) deficiency in the stance phase of gait cycle, as compared with those in the model without ligamentous deficiency. In two or more multiple ligamentous deficiencies, contact stresses on the PE insert and articular lateral cartilage and quadriceps force were significantly increased versus in the case of single-ligament deficiency. Conclusion: Poor outcomes of medial UKA in patients with ACL or MCL deficiency can be predicted. Care should be taken to extend the indications when performing medial UKA in patients with ligamentous deficiency, especially when varus knee with ACL or MCL deficiency is present.
Full Text
https://link.springer.com/article/10.1007/s00167-019-05636-7
DOI
10.1007/s00167-019-05636-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Min(권혁민) ORCID logo https://orcid.org/0000-0002-2924-280X
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179966
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