Zhenxian Chen, Jianian Han, Jing Zhang, Yinghu Peng, Lei Guo, Shibin Chen, Zhongmin Jin
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引用次数: 0
Abstract
Aseptic loosening is the primary cause of failure following posterior-stabilized total knee arthroplasty. It is unclear whether tibial post loading of posterior-stabilized prosthesis increases the risk of aseptic loosening of the tibial prosthesis. The purpose of this study is to investigate the biomechanical effects of tibial post loading on the tibial prosthesis fixation interface during level walking, squatting, stair descent, and standing up-sitting down activities. In this paper, finite element models with and without post were established to compare the effects of tibial post loading on the von Mises stress of the proximal tibia, shear stress of the cement, and the bone-prosthesis interface micromotion during four physiological activities. The tibial post loading had an insignificant influence on tibial biomechanics and bone-prosthesis interface micromotion during leveling walking activity. However, compared to the insert without post condition, tibial post loading significantly increased the maximum tibial von Mises stress, the maximum shear stress in the medial of cement, and the bone-prosthesis interface peak micromotion by 912.84%, 612.77%, and 921.09%, respectively, at the moment of the maximum flexion angle for the stair descent activity, and 637.92%, 351.43%, and 519.13%, respectively, at the moment of the maximum flexion angle for the standing up-sitting down activity. Tibial post loading increased the risk of postoperative aseptic loosening of tibial prosthesis in patients with posterior-stabilized total knee arthroplasty, and it was recommended that the post-cam contact mechanism of posterior-stabilized prosthesis should be optimized to reduce the biomechanical impact of tibial post loading on tibial prosthesis fixation.
无菌性松动是后稳定全膝关节置换术失败的主要原因。目前尚不清楚后稳定假体的胫骨后加载是否会增加胫骨假体无菌性松动的风险。本研究旨在探讨在平地行走、下蹲、下楼梯和起立-坐下活动中,胫骨后加载对胫骨假体固定界面的生物力学影响。本文建立了带柱和不带柱的有限元模型,比较了胫骨柱加载对四种生理活动中胫骨近端 von Mises 应力、骨水泥剪应力和骨假体界面微动的影响。在平步行走活动中,胫骨支柱加载对胫骨生物力学和骨假体界面微动的影响不大。然而,与无衬垫条件相比,胫骨衬垫加载显著增加了胫骨最大冯米塞斯应力、骨水泥内侧最大剪应力和骨假体界面峰值微动,在下楼梯活动的最大屈曲角时刻分别增加了912.84%、612.77%和921.09%,在站立-坐下活动的最大屈曲角时刻分别增加了637.92%、351.43%和519.13%。胫骨后负荷增加了后稳定全膝关节置换术患者胫骨假体术后无菌性松动的风险,建议优化后稳定假体的后凸接触机制,以减少胫骨后负荷对胫骨假体固定的生物力学影响。
期刊介绍:
The Journal of Engineering in Medicine is an interdisciplinary journal encompassing all aspects of engineering in medicine. The Journal is a vital tool for maintaining an understanding of the newest techniques and research in medical engineering.