scholarly journals Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

2012 ◽  
Vol 7 (1) ◽  
pp. 28 ◽  
Author(s):  
Hans-Peter W van Jonbergen ◽  
Bernardo Innocenti ◽  
Gian Gervasi ◽  
Luc Labey ◽  
Nico Verdonschot
2021 ◽  
Author(s):  
Morshed Khandaker ◽  
Onur Can Kalay ◽  
Fatih Karpat ◽  
Amgad Haleem ◽  
Wendy Williams ◽  
...  

Author(s):  
Morshed Khandaker ◽  
Onur Can Kalay ◽  
Fatih Karpat ◽  
Amgad Haleem ◽  
Wendy Williams ◽  
...  

Abstract A method to improve the mechanical fixation of a total knee replacement (TKR) implant is clinically important and is the purpose of this study. More than one million joint replacement procedures are performed in people each year in the United States, and experts predict the number to increase six-fold by the year 2030. Whether cemented or uncemented, joint prostheses may destabilize over time and necessitate revision. Approximately 40,000 hip arthroplasty surgeries have to be revised each year and the rate is expected to increase by approximately 140% (and by 600% for total knee replacement) over the next 25 years. In veterinary surgery, joint replacement has a long history and the phenomenon of surgical revision is also well recognized. For the betterment of both people and animals, improving the longevity of arthroplasty devices is of the utmost clinical importance, and towards that end, several strategies are under investigation. One approach that we explore in the present research is to improve the biomechanical performance of cemented implant systems by altering the implant surface architecture in a way that facilitates its cement bonding capacity. Beginning with the Charnley system, early femoral stems were polished smooth, but a number of subsequent designs have featured a roughened surface — created with bead or grit blasting — to improve cement bonding. Failure at the implant-cement interface remains an issue with these newer designs, leading us to explore in this present research an alternate, novel approach to surface alteration — specifically, laser microgrooving. This study used various microgrooves architectures that is feasible using a laser micromachining process on a tibia tray (TT) for the goat TKR. Developing the laser microgrooving (LM) procedure, we hypothesized feasibility in producing parallel microgrooves of precise dimensions and spacing on both flat and round metallic surfaces. We further hypothesized that laser microgrooving would increase surface area and roughness of the cement interface of test metallic implants and that such would translate into an improved acute mechanical performance as assessed in vitro under both static and cyclic loads. The objective was to develop a computational model to determine the effect of LIM on the tibial tray to the mechanical stimuli distributions from implant to bone using the finite element method. This study designed goat TT 3D solid model from a computer topography (CT) images, out of which three different laser microgrooves were engraved on TT sample by varying depth, height and space between two adjacent grooves. The simulation test results concluded that microgrooves acchitecures positively influence microstrain behavior around the implant/bone interfaces. There is a higher amount of strain observed for microgroove implant/bone samples compared to non-groove implant/bone samples. Thus, the laser-induced microgrooves have the potential to be used clinically in TKR components.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Farhan Syed ◽  
Edward Jenner ◽  
Mohammad Faisal

Metal allergy is an unusual complication of joint replacement that may cause aseptic loosening and necessitate joint revision surgery. We present the case of nickel allergy causing aseptic loosening following patellofemoral joint replacement (PFJR) in a 54-year-old male. Joint revision surgery to a nickel-free total knee replacement was performed with good results. Our literature review shows that there is no evidence to guide the management of metal allergy in PFJR. The evidence from studies of total knee replacement is limited to retrospective case series and case reports and gives contradictory recommendations. The optimal management strategy for metal allergy in PFJR is not clear. We recommend allergy testing in patients with history of metal allergy and use of an allergen-free implant in those with positive tests. As there is no gold standard test to establish metal allergy, the choice of test should be guided by availability and recommendation from the local unit of dermatology and allergy testing. We recommend investigation for metal allergy in patients with implant loosening where other causes have been excluded.


Author(s):  
J F Shi ◽  
C J Wang ◽  
T Laoui ◽  
W Hart ◽  
R Hall

The aim of this study has been to develop a dynamic model of the knee joint after total knee replacement (TKR) to analyse the stress distribution in the distal femur during daily activities. Using MSC/ADAMS and MSC/MARC software, a dynamic model of an implanted knee joint has been developed. This model consists of the components of the knee prosthesis as well as the bones and ligaments of the knee. The femur, tibia, fibula, and patella have been modelled as mixed cortico-cancellous bone. The distal part of femur has been modelled as a flexible body with springs used to simulate the ligaments positioned at their anatomical insertion points. With this dynamic model a gait cycle was simulated. Stress shielding was identified in the distal femur after TKR, which is consistent with other investigators' results. Interestingly, higher stresses were found in the bone adjacent to the femoral component peg. This dynamic model can now be used to analyse the stress distribution in the distal femur with different load conditions. This will help to improve implant designs and will allow comparison of prostheses from different manufacturers.


2014 ◽  
Vol 931-932 ◽  
pp. 1122-1128
Author(s):  
Surasith Piyasin ◽  
Kriengkrai Nabudda ◽  
Suwipong Hemathulin

Nowadays, patients with osteoarthritis in Thailand are likely to increase in number every year. There are approximately 462,000 people and most are females than males. The treatment is surgery knee replacement implants which must be imported from abroad and cost is expensive.Total knee prosthesis used in Thailand would not fit with the body of the Thai women because of the design total knee prosthesis use anatomical data of Europe and designed for both male and female, which is different in the knee structure. This research aims to study the size and shape of knee for Thai women and design total knee replacement. The using of finite elements is to assist in the analysis which focuses on the influence of the force active on and the effects of stress distribution on the part of the knee at different stages of gait cycle. The results of the study can measure the average size of Thai knee women base on analytical data. Anthropometric data on the proximal tibia and distal femur of 55 female knees were obtained using three dimensional computer tomographic measurements. The parametric studies are dimension analysis of the femoral mediolateral (fML) and femoral anteroposterior (fAP) dimension on distal femur surface and tibial mediolateral (tML), tibial anteroposterior (tAP) on proximal tibia surface. The measuring average values are 65, 60, 67 and 45 mm respectively. All parameters were compared to the size of the total knee prosthesis which currently used in Thailand. It is found that values are 70, 62, 68 and 48 mm respectively which is larger than the average Thai woman.The study of finite elements can be made aware of the stress distribution and stress in the area of artificial knee while walking and leading to the design of artificial knee joint to have size and shape suitable for Thai women.


1992 ◽  
Vol 25 (12) ◽  
pp. 1413-1424 ◽  
Author(s):  
R.L. Rakotomanana ◽  
P.F. Leyvraz ◽  
A. Curnier ◽  
J.H. Heegaard ◽  
P.J. Rubin

2017 ◽  
Vol 44 (11) ◽  
pp. 1723-1726 ◽  
Author(s):  
Jasvinder A. Singh ◽  
Michelle M. Dowsey ◽  
Michael Dohm ◽  
Susan M. Goodman ◽  
Amye L. Leong ◽  
...  

Objective.Discussion and endorsement of the OMERACT total joint replacement (TJR) core domain set for total hip replacement (THR) and total knee replacement (TKR) for endstage arthritis; and next steps for selection of instruments.Methods.The OMERACT TJR working group met at the 2016 meeting at Whistler, British Columbia, Canada. We summarized the previous systematic reviews, the preliminary OMERACT TJR core domain set and results from previous surveys. We discussed preliminary core domains for TJR clinical trials, made modifications, and identified challenges with domain measurement.Results.Working group participants (n = 26) reviewed, clarified, and endorsed each of the inner and middle circle domains and added a range of motion domain to the research agenda. TJR were limited to THR and TKR but included all endstage hip and knee arthritis refractory to medical treatment. Participants overwhelmingly endorsed identification and evaluation of top instruments mapping to the core domains (100%) and use of subscales of validated multidimensional instruments to measure core domains for the TJR clinical trial core measurement set (92%).Conclusion.An OMERACT core domain set for hip/knee TJR trials has been defined and we are selecting instruments to develop the TJR clinical trial core measurement set to serve as a common foundation for harmonizing measures in TJR clinical trials.


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