Biomechanical effects of femoral prosthesis misalignment on the structure of the lateral compartment during medial unicompartmental knee arthroplasty in osteoporotic patients.

IF 1.6 4区 医学
Mengfei Liu, Kan Jiang, Xiaochen Ju
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Abstract

Background: This study aims to investigate the impact of varying coronal alignments of femoral prostheses on stress and strain distributions within the lateral compartment following unicompartmental knee arthroplasty (UKA) in patients with normal bone density and osteoporosis using finite element analysis. Additionally, it examines the relationship between osteoporosis and the progression of osteoarthritis in the lateral compartment postoperatively.

Methods: UKA models were developed for both normal bone and osteoporotic conditions using a validated finite element model of the knee. Seven alignment conditions for the femoral prosthesis were simulated: 0° (neutral alignment), varus angles of 3°, 6°, and 9°, and valgus angles of 3°, 6°, and 9°, resulting in a total of 14 scenarios. Stress and strain distributions in the meniscus, tibial cartilage, and femoral cartilage of the lateral compartment were evaluated.

Results: The results indicated that stress and strain in the meniscus, tibial cartilage, and femoral cartilage of the lateral compartment increased with greater varus alignment and decreased with greater valgus alignment in both normal and osteoporotic models. At equivalent alignment angles, stress and strain were consistently higher in the osteoporotic model (M2) compared to the normal bone model (M1), although the peak equivalent stress in the tibial cartilage was lower in the M2 model than in the M1 model.

Conclusions: In patients with osteoporosis undergoing fixed-bearing medial UKA, varus malalignment of the femoral prosthesis can lead to increased stress and strain in the lateral compartment's meniscus, tibial cartilage, and femoral cartilage. These findings suggest that osteoporosis may contribute to abnormal stress and strain distributions in the lateral compartment following UKA, potentially accelerating the progression of osteoarthritis in this region postoperatively.

骨质疏松患者进行内侧单室膝关节置换术时,股骨假体错位对外侧室结构的生物力学影响。
背景:本研究旨在利用有限元分析方法,研究股骨假体不同的冠状排列对骨密度正常和骨质疏松症患者进行单髁膝关节置换术(UKA)后外侧室应力和应变分布的影响。此外,该研究还探讨了骨质疏松症与术后侧室骨关节炎进展之间的关系:方法:使用经过验证的膝关节有限元模型,为正常骨质和骨质疏松情况建立了 UKA 模型。模拟了股骨假体的七种对位条件:0°(中性排列)、3°、6°和9°的外翻角以及3°、6°和9°的内翻角,共模拟了14种情况。对半月板、胫骨软骨和股骨外侧软骨的应力和应变分布进行了评估:结果表明,在正常模型和骨质疏松模型中,半月板、胫骨软骨和外侧室股骨软骨的应力和应变随着屈曲对齐角度的增大而增大,随着外翻对齐角度的增大而减小。在同等对位角度下,骨质疏松模型(M2)的应力和应变始终高于正常骨骼模型(M1),尽管M2模型中胫骨软骨的峰值等效应力低于M1模型:结论:骨质疏松症患者在接受固定轴承内侧UKA手术时,股骨假体的曲度错位会导致外侧半月板、胫骨软骨和股骨头软骨的应力和应变增加。这些研究结果表明,骨质疏松症可能会导致UKA术后外侧室的应力和应变分布异常,从而有可能加速术后该区域骨关节炎的发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
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发文量
91
期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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