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Finite element analysis of the influence of the posterior tibial slope on mobile-bearing unicompartmental knee arthroplasty

Authors
 Yong-Gon Koh  ;  Kyoung-Mi Park  ;  KiWon Kang  ;  Paul Shinil Kim  ;  Young Han Lee  ;  Kwan Kyu Park  ;  Kyoung-Tak Kang 
Citation
 KNEE, Vol.29 : 116-125, 2021-03 
Journal Title
KNEE
ISSN
 0968-0160 
Issue Date
2021-03
MeSH
Arthroplasty, Replacement, Knee* ; Biomechanical Phenomena / physiology* ; Computer Simulation ; Finite Element Analysis ; Gait Analysis ; Humans ; Knee Joint / physiology* ; Knee Prosthesis* ; Models, Biological ; Prosthesis Fitting* ; Stress, Mechanical
Keywords
Finite element analysis ; Mobile-type unicompartmental knee arthroplasty ; Posterior tibial slope
Abstract
Background: The most common modes of failure reported in unicompartmental knee arthroplasty (UKA) in its first two decades were wear on the polyethylene (PE) insert, component loosening, and progressive osteoarthritis in the other compartment. The rates of implant failure due to poor component positioning in patients who have undergone UKA have been reported. However, the effect of the posterior tibial slope on the biomechanical behavior of mobile-bearing Oxford medial UKA remains unknown.

Methods: We applied finite element (FE) analysis to evaluate the effects of the posterior tibial slope in mobile-bearing UKA on the contact stresses in the superior and inferior surfaces of PE inserts and articular cartilage as well as the forces exerted on the anterior cruciate ligament (ACL). Seven FE models for posterior tibial slopes of -1°, 1°, 3°, 5°, 7°, 9°, and 11° were developed and analyzed under normal-level walking conditions based on this approach.

Results: The maximum contact stresses on both the superior and inferior surfaces of the PE insert decreased as the posterior tibial slope increased. However, the maximum contact stress on the lateral articular cartilage and the force exerted on the ACL increased as the posterior tibial slope increased.

Conclusions: Increasing the tibial slope led to a reduction in the contact stress on the PE insert. However, a high contact stress on the other compartment and increased ACL force can cause progressive osteoarthritis in the other compartment and failure of the ACL.
Full Text
https://www.sciencedirect.com/science/article/pii/S0968016021000053
DOI
10.1016/j.knee.2021.01.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184747
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