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Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study

Authors
 Hyuck Min Kwon  ;  Hyoung-Taek Hong  ;  Inuk Kim  ;  Byung Woo Cho  ;  Yong-Gon Koh  ;  Kwan Kyu Park  ;  Kyoung-Tak Kang 
Citation
 JOURNAL OF KNEE SURGERY, Vol.37(13) : 879-886, 2024-11 
Journal Title
JOURNAL OF KNEE SURGERY
ISSN
 1538-8506 
Issue Date
2024-11
MeSH
Arthroplasty, Replacement, Knee* ; Biomechanical Phenomena ; Finite Element Analysis* ; Humans ; Knee Prosthesis* ; Prosthesis Design ; Stress, Mechanical ; Tibia* / surgery
Abstract
The aim of this study was to investigate the biomechanical effects of stem extension with a medial tibial bone defect in primary total knee arthroplasty (TKA) on load distribution and stress in the proximal tibia using finite element (FE) analysis.FE simulations were performed on the tibia bone to evaluate the stress and strain on the tibia bone and bone cement. This was done to investigate the stress shielding effect, stability of the tibia plate, and the biomechanical effects in TKA models with various medial defects and different stem length models.The results demonstrated that in the bone defect model, the longer the stem, the lower the average von Mises stress on the cortical and trabecular bones. In particular, as the bone defect increased, the average von Mises stress on cortical and trabecular bones increased. The average increase in stress according to the size of the bone defect was smaller in the long stem than in the short stem. The maximal principal strain on the trabecular bone occurred mainly at the contact point on the distal end of the stem of the tibial implant. When a short stem was applied, the maximal principal strain on the trabecular bone was approximately 8% and 20% smaller than when a long stem was applied or when no stem was applied, respectively.The findings suggest that a short stem extension of the tibial component could help achieve excellent biomechanical results when performing TKA with a medial tibial bone defect.
Full Text
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2344-5084
DOI
10.1055/a-2344-5084
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
Cho, Byung Woo(조병우) ORCID logo https://orcid.org/0000-0002-7472-4103
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200892
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