Optimization of Tibial Stem Geometry in Total Knee Arthroplasty Using Design of Experiments: A Finite Element Analysis.

The stability of the tibial component in Total Knee Arthroplasty (TKA) is critical to preventing aseptic loosening, a major cause of implant failure. However, existing tibial stem designs often lead to stress shielding and bone resorption, highlighting the need for further optimization. This study addresses these challenges by employing the Design of Experiments (DOE) methodology, specifically utilizing a full factorial design approach combined with finite element analysis (FEA), to optimize the geometry of the tibial stem. The material properties of the cortical and cancellous bone, as well as the tibial tray, were assigned based on values from the literature, representing their elastic moduli and Poisson's ratios. For boundary conditions, the distal end of the tibia was fully constrained to simulate realistic load transfer, while compressive loads representative of walking and daily activities were applied to the tibial base. Key design parameters, including stem diameter, length, mediolateral ratio (M/L ratio), and wing angle, were systematically analyzed. The results identified stem diameter and length as the most influential factors in improving biomechanical performance, while the wing angle showed minimal impact. The optimized design, featuring a stem diameter of 12 mm, length of 40 mm, M/L ratio of 0.61, and a wing angle of 60°, demonstrated significant reductions in stress shielding and aseptic loosening compared to conventional models. These findings provide valuable insights into enhancing the long-term success of TKA implants by balancing implant stability and minimizing bone resection.