Tibial tray stability in three cementless total knee arthroplasty systems

IF 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL
John Kyle Mueller , Charles Lawrie , Charlie Parduhn , Jeff Bischoff , Eik Siggelkow , Cory Trischler , Marc Bandi
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引用次数: 0

Abstract

Background

Initial stability of cementless total knee arthroplasty tibial trays is necessary for bony ingrowth. The purpose of this study was to characterize the patterns and magnitudes of displacement of three implant systems during physiological loading in terms of tibial tray movement and 3D micromotion.

Methods

Physiological loading (walking and stair descent) from a representative subject was robotically applied to cementless tibial trays implanted in foam tibia models. Three commercially available total knee arthroplasty systems with cementless tibial trays with keels and peripheral pegs from two different manufacturers were tested including symmetric, asymmetric and anatomically shaped tibial trays. Relative displacement between the foam tibia model and tibial tray in response to loading was measured at ten peripheral locations using an optical measurement system.

Findings

All systems showed inferior movement of the posterior tibial tray in response to posterior located tibiofemoral loading, and superior movement of the anterior tibial tray. The system with an anatomic tibial tray design had significantly less micromotion than the systems with an asymmetric and symmetric tibial tray designs during walking (symmetric: 229 ± 30 μm, asymmetric: 205 ± 54 μm, anatomic: 84 ± 22 μm; p < 0.001) and less micromotion than the symmetric tibial tray during stair descent (symmetric: 165 ± 17 μm, asymmetric: 151 ± 65 μm, anatomic: 92 ± 18 μm; p < 0.002).

Interpretation

Total knee arthroplasty system design had an impact on keeled cementless tibial tray initial stability during simulated walking and stair descent in this biomechanical model.
三种无骨水泥全膝关节置换术中胫骨托盘的稳定性
背景:无骨水泥全膝关节置换术胫骨托盘的初步稳定性对骨长入是必要的。本研究的目的是根据胫骨托盘运动和三维微运动来描述生理负荷期间三种种植体系统的位移模式和大小。方法将代表性受试者的生理负荷(步行和下楼梯)机器人应用于泡沫胫骨模型植入的无水泥胫骨托盘。我们测试了来自两家不同制造商的三种商用全膝关节置换术系统,包括对称、不对称和解剖形状的胫骨托盘。利用光学测量系统测量了泡沫胫骨模型与胫骨托盘在10个外围位置响应载荷时的相对位移。结果:所有系统均表现为胫骨后托盘的下移,以响应位于胫骨股骨后的负荷,以及胫骨前托盘的上移。采用解剖式胫骨托架设计的系统在行走时的微动明显小于采用不对称和对称胫骨托架设计的系统(对称:229±30 μm,不对称:205±54 μm,解剖:84±22 μm; p < 0.001),在楼梯下走时的微动明显小于对称胫骨托架设计的系统(对称:165±17 μm,不对称:151±65 μm,解剖:92±18 μm; p < 0.002)。在这个生物力学模型中,全膝关节置换术系统的设计对模拟行走和楼梯下降过程中龙骨无水泥胫骨托盘的初始稳定性有影响。
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来源期刊
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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