scholarly journals Influences of Different Implant Material Combinations on the Stress Distribution of the Foot Following Total Ankle Replacement: a Finite Element Analysis

2021 ◽  
Author(s):  
Jian Yu ◽  
Dahang Zhao ◽  
Wen-Ming Chen ◽  
Pengfei Chu ◽  
Shuo Wang ◽  
...  
Keyword(s):  
Finite Element ◽  
Articular Surface ◽  
Reaction Force ◽  
Total Ankle Replacement ◽  
Von Mises Stress ◽  
Cobalt Chromium ◽  
Polyether Ether Ketone ◽  
Implant Material ◽  
Ankle Replacement ◽  
Ether Ketone

Abstract Background A proper combination of implant materials for Total Ankle Replacement (TAR) may reduce stress at the implant and the foot. This study aimed to investigate the biomechanical influences for different implant material combinations using the finite element (FE) method. Methods A validated foot model was modified to simulate TAR with the INBONE II ankle system at the second peak ground reaction force. Six types of materials were used (Ceramic, cobalt–chromium–molybdenum alloy (CoCrMo), Titanium alloy (Ti6Al4V), carbon-fiber-reinforced Polyether-ether-ketone (CFR-PEEK), Polyether-ether-ketone (PEEK), and used ultra-high molecular weight polyethylene (UHMWPE)). Results The von Mises stress at the bearing articular surface decreased with implant stiffness. The combination of CFR-PEEK on UHMWPE presented the lowest stress of 14.82 MPa. A low implant stiffness of the talar component, rather than the bearing, relieved the stress at the resected surface of the talus. Conclusions Soft implant material provided a stress reduction at the bearing and adjacent bones. CFR-PEEK seemed to be a good alternative to implant metal components.

scholarly journals Custom-made talar component of total ankle replacement implant, with or without lateral articular facet: A finite element analysis

2020 ◽  
Author(s):  
Min Zhu ◽  
Kang-lai Tang ◽  
Zhong-min Jin ◽  
Zhi Xu ◽  
Guo-cheng Feng ◽  
...  
Keyword(s):  
Finite Element ◽  
Contact Surface ◽  
Total Ankle Replacement ◽  
Von Mises Stress ◽  
Patient Specific ◽  
Contact Type ◽  
Articular Facet ◽  
Ankle Replacement ◽  
Custom Made ◽  
Surface Contact

Abstract Background: The present patient dissatisfaction with and high failure rates of total ankle replacement (TAR) are likely due to current prosthesis designs, which are not patient-specific and anatomy-based, leading to unphysiological motion at the replaced joint. The design of customized prostheses is already possible by means of medical imaging and additive manufacturing technology.Methods: In this study, dome and geometric fixtures of custom-made talar components for TAR were designed, and we investigated two kinds of talar components: 2-surface contact type (Type-1, without lateral articular facet) and 3-surface contact type (Type-2, with lateral articular facet). The effects of the above two prostheses on the loading stress of the prosthesis contact surface were comparatively analysed with three-dimensional finite element models.Results: The maximum and average von Mises stress values of the 3-surface prosthesis were smaller than those of the 2-surface prosthesis. In terms of contact surface pressure, the maximum and average values of the 3-surface prosthesis are almost equal to those of the 2- surface type. In terms of the tangential slip distribution of the contact surface, the maximum and average values of the 3-surface prosthesis were smaller than those of the 2-surface prosthesis.Conclusions: The custom-made talar component of the total ankle replacement implant reproduced the anatomical morphology of the natural articular surfaces well. The 3-surface contact type prosthesis with lateral articular facet, compared to the 2-surface contact type without lateral articular facet, offers better static stability by affecting the internal and external forces.

scholarly journals 3D Finite Element Analysis of Rotary Instruments in Root Canal Dentine with Different Elastic Moduli

2021 ◽  
Vol 11 (6) ◽  
pp. 2547 ◽  
Author(s):  
Carlo Prati ◽  
João Paulo Mendes Tribst ◽  
Amanda Maria de Oliveira Dal Piva ◽  
Alexandre Luiz Souto Borges ◽  
Maurizio Ventre ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Root Canal ◽  
Elastic Moduli ◽  
Reaction Force ◽  
Von Mises Stress ◽  
Elastic Behavior ◽  
Element Analysis ◽  
Heat Treated ◽  
Von Mises

The aim of the present investigation was to calculate the stress distribution generated in the root dentine canal during mechanical rotation of five different NiTi endodontic instruments by means of a finite element analysis (FEA). Two conventional alloy NiTi instruments F360 25/04 and F6 Skytaper 25/06, in comparison to three heat treated alloys NiTI Hyflex CM 25/04, Protaper Next 25/06 and One Curve 25/06 were considered and analyzed. The instruments’ flexibility (reaction force) and geometrical features (cross section, conicity) were previously investigated. For each instrument, dentine root canals with two different elastic moduli(18 and 42 GPa) were simulated with defined apical ratios. Ten different CAD instrument models were created and their mechanical behaviors were analyzed by a 3D-FEA. Static structural analyses were performed with a non-failure condition, since a linear elastic behavior was assumed for all components. All the instruments generated a stress area concentration in correspondence to the root canal curvature at approx. 7 mm from the apex. The maximum values were found when instruments were analyzed in the highest elastic modulus dentine canal. Strain and von Mises stress patterns showed a higher concentration in the first part of curved radius of all the instruments. Conventional Ni-Ti endodontic instruments demonstrated higher stress magnitudes, regardless of the conicity of 4% and 6%, and they showed the highest von Mises stress values in sound, as well as in mineralized dentine canals. Heat-treated endodontic instruments with higher flexibility values showed a reduced stress concentration map. Hyflex CM 25/04 displayed the lowest von Mises stress values of, respectively, 35.73 and 44.30 GPa for sound and mineralized dentine. The mechanical behavior of all rotary endodontic instruments was influenced by the different elastic moduli and by the dentine canal rigidity.

scholarly journals Finite-element analysis of the influence of tibial implant fixation design of total ankle replacement on bone–implant interfacial biomechanical performance

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096612
Author(s):  
Jian Yu ◽  
Chao Zhang ◽  
Wen-Ming Chen ◽  
Dahang Zhao ◽  
Pengfei chu ◽  
...  
Keyword(s):  
Finite Element ◽  
Total Ankle Replacement ◽  
Implant Design ◽  
Fixation Method ◽  
Implant Loosening ◽  
Implant Fixation ◽  
Bone Resection ◽  
Bone Implant ◽  
Initial Stability ◽  
Ankle Replacement

Purpose: Implant loosening in tibia after primary total ankle replacement (TAR) is one of the common postoperative problems in TAR. Innovations in implant structure design may ideally reduce micromotion at the bone–implant interface and enhance the bone-implant fixation and initial stability, thus eventually prevents long-term implant loosening. This study aimed to investigate (1) biomechanical characteristics at the bone–implant interface and (2) the influence of design features, such as radius, height, and length. Methods: A total of 101 finite-element models were created based on four commercially available implants. The models predicted micromotion at the bone–implant interface, and we investigated the impact of structural parameters, such as radius, length, and height. Results: Our results suggested that stem-type implants generally required the highest volume of bone resection before implantation, while peg-type implants required the lowest. Compared with central fixation features (stem and keel), peripherally distributed geometries (bar and peg) were associated with lower initial micromotions. The initial stability of all types of implant design can be optimized by decreasing fixation size, such as reducing the radius of the bars and pegs and lowering the height. Conclusion: Peg-type tibial implant design may be a promising fixation method, which is required with a minimum bone resection volume and yielded minimum micromotion under an extreme axial loading scenario. Present models can serve as a useful platform to build upon to help physicians or engineers when making incremental improvements related to implant design.

scholarly journals Peri-implant cartilage and bone histological changes following treatment of focal osteochondral defects in the femoral head with polyether ether ketone implants versus cobalt chromium molybdenum alloy implants: assessment in a goat model

2020 ◽  
Author(s):  
Zhiguo Yuan ◽  
Wei Zhang ◽  
Xiangchao Meng ◽  
Jue Zhang ◽  
Teng TengLong ◽  
...  
Keyword(s):  
Femoral Head ◽  
Osteochondral Defect ◽  
Osteochondral Defects ◽  
Cobalt Chromium ◽  
Cocrmo Alloy ◽  
Polyether Ether Ketone ◽  
Histological Score ◽  
Ether Ketone ◽  
Cobalt Chromium Molybdenum

Abstract Objective: This study aimed to quantitatively investigate the peri-implant histology of applying defect-size polyether ether ketone (PEEK) implant for the treatment of localized osteochondral defects in the femoral head and compared it with cobalt chromium molybdenum (CoCrMo) alloy implant.Methods: A femoral head osteochondral defect model was created in the left hips of goats (n=12). Defects were randomly treated by immediate placement of a PEEK (n=6) or CoCrMo implant (n=6). The un-operated right hip joints served as a control. Goats were sacrificed at 12 weeks. Periprosthetic cartilage quality was semi-quantitatively analyzed macroscopically and microscopically. Implant osseointegration was measured by micro-CT and histomorphometry.Results: The modified macroscopic articular evaluation score in the PEEK group was lower than that in the CoCrMo group (p<0.05), and the histological score of the periprosthetic and acetabular cartilage in the PEEK group was lower than that in the CoCrMo group (P<0.05). The mean bone-implant contact for PEEK implants was comparable with that for CoCrMo alloy implants at 12 weeks.Conclusions: A PEEK implant for the treatment of local osteochondral defect in the femoral head demonstrated effective fixation and superior in vivo cartilage protection compared with an identical CoCrMo alloy implant.

scholarly journals Syndesmotic Instability After Total Ankle Replacement

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0010
Author(s):  
Roxa Ruiz ◽  
Lukas Zwicky ◽  
Beat Hintermann
Keyword(s):  
Ankle Joint ◽  
Tibial Component ◽  
External Rotation ◽  
Articular Surface ◽  
Cyst Formation ◽  
Total Ankle Replacement ◽  
Hindfoot Alignment ◽  
Additional Degree ◽  
Component Design ◽  
Ankle Replacement

Category: Ankle Arthritis Introduction/Purpose: Total ankle replacement (TAR) evolved over the last decades and has been shown to be an effective concept in the treatment of ankle osteoarthritis (OA). In three-component designs, the second interface between polyethylene insert (PI) and tibial component allows the PI to find its position according the individual physiological properties. This was believed to decrease shear forces within the ankle joint. However, it is not clarified to which extent such an additional degree of freedom may overload the ligamentous structures of the ankle joint over time. This may in particular be the case for the syndesmotic ligaments. Therefore, the purpose of this study was to analyze all ankles after TAR that showed a symptomatic overload of the syndesmotic ligaments and to determine the potential consequences. Methods: Between 2003 and 2017, 31 ankles (females, 17; males 14; mean age 60 [40-79] years) were treated with a tibio-fibular fusion for a symptomatic instability of the syndesmosis. The indication for TAR was posttraumatic OA in 27 (87%), primary OA in 3 (10%), and hemochromatosis in one ankle (3%). The 31 ankles included 23 primary TAR (74%), 6 revision TAR (19%), and two take-down of a fusion and conversion to TAR (7%). Criteria for fusion were the presence of at least two of the followings: (1) tenderness over the syndesmosis, (2) pain while compressing the fibula against the tibia (squeeze test), (3) pain while rotating the foot externally (external rotation test), (4) widening of the syndesmosis on an anteroposterior view. Alignment of TAR (tibial articular surface [TAS] angle) and hindfoot alignment were measured on standard radiographs. Intraoperatively, the syndesmotic instability was confirmed before fusion. The wear of PI was documented. Results: After a mean of 63 (range, 4 – 152) months after TAR, all patients evidenced pain at the level of the syndesmosis of at least 3 months. 25 ankles (81%; 24 after posttraumatic OA) showed a widening of the syndesmotic space and 22 ankles (71%) of the medial clear space with lateral translation of the talus. The PI was seen to overlap the tibial component in 15 ankles (48%). Nine ankles (29%) evidenced cyst formation, and eight ankles (26%) showed a decrease in height of the PI; whereas, in 3 ankles (10%) a fracture of the PI was found. A valgus misalignment of the heel was found in 25 ankles (81%), a valgus TAS in 16 (52%) and a varus TAS in 11 ankles (36%). Conclusion: A syndesmotic instability after a three-component TAR apparently occurred mostly after posttraumatic OA, in particular if the heel was left in valgus. If the talus starts to move lateralward, the PI seems to be at risk for increased wear and finally mechanical failure (Figure 1). Therefore, a valgus misaligned heel should always be corrected during TAR implantation. If there is any sign of syndesmotic instability, a fusion should be considered. Further studies must proof whether in cases with a syndesmotic instability the use of a two-component design will be superior, as it stabilizes the talus in the coronal plane.

scholarly journals Effects of Surface Modification and Bulk Geometry on the Biotribological Behavior of Cross-Linked Polyethylene: Wear Testing and Finite Element Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Kenichi Watanabe ◽  
Masayuki Kyomoto ◽  
Kenichi Saiga ◽  
Shuji Taketomi ◽  
Hiroshi Inui ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Creep Deformation ◽  
Polyethylene Wear ◽  
Wear Testing ◽  
Von Mises Stress ◽  
Cross Linking ◽  
Bearing Surface ◽  
Cobalt Chromium ◽  
Element Analysis

The wear and creep deformation resistances of polymeric orthopedic bearing materials are both important for extending their longevity. In this study, we evaluated the wear and creep deformation resistances, including backside damage, of different polyethylene (PE) materials, namely, conventional PE, cross-linked PE (CLPE), and poly(2-methacryloyloxyethyl phosphorylcholine)- (PMPC-) grafted CLPE, through wear tests and finite element analysis. The gravimetric and volumetric degrees of wear of disks (3 or 6 mm in thickness) of these materials against a cobalt-chromium-molybdenum alloy pin were examined using a multidirectional pin-on-disk tester. Cross-linking and PMPC grafting decreased the gravimetric wear of the PE disks significantly. The volumetric wear at the bearing surface and the volumetric penetration in the backside of the 3-mm thick PE disk were higher than those of the 6-mm thick PE disk, regardless of the bearing material. The geometrical changes induced in the PE disks consisted of creep, because the calculated internal von Mises stress at the bearing side of all disks and that at the backside of the 3-mm thick disks exceeded their actual yield strengths. A highly hydrated bearing surface layer, formed by PMPC grafting, and a cross-linking-strengthened substrate of adequate thickness are essential for increasing the wear and creep deformation resistances.

scholarly journals Transfibular Total Ankle Replacement Outcome at 2 Years Follow Up

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Camilla Maccario ◽  
Cristian Indino ◽  
Luigi Manzi ◽  
Federico Giuseppe Usuelli ◽  
Claudia Di Silvestri
Keyword(s):  
Normal Values ◽  
Short Form ◽  
Articular Surface ◽  
Total Ankle Replacement ◽  
Fixed Bearing ◽  
Trabecular Metal ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Ankle Replacement

Category: Ankle, Ankle Arthritis Introduction/Purpose: Primary ankle osteoarthritis is very uncomon, in fact 70-78% of the case ankle arthritis has a post- traumatic cause. Ankle arthrodesis (AA), has been considered a reliable procedure for resolution of ankle osteoarthritis. Recent modifications in Total ankle replacement (TAR) designs have challenged the perception that AA is the treatment of choice for end-stage ankle arthritis. Trabecular Metal Total Ankle system is a fixed-bearing prosthesis. The new design is flanked by use of new materials. The tibial articular surface is constructed of highly crosslinked UHMWPE and Trabecular Metal lining the talar and the tibial base component. The purpose of this retrospective study was to show the preliminary result in 31 patients underwent to ankle replacement using Zimmer Trabecular Metal Total Ankle system. Methods: We retrospectively assessed prospectively collected data on the initial cohort of 31 patients undergoing TAR with this implant. Clinical evaluation was determined pre and postoperatively for a minimum of 24 months after surgery. Pain was rated using the visual analogue scale (VAS). Functional results were assessed as well as ankle range of motion (ROM). Clinical outcomes used where the Short Form SF-12 Quality of Life score, the American Foot and Ankle Society (AOFAS). The imaging follow-up included ankle radiographs done at 6, 12 and 24 months. Radiological parameters were angles??(normal values 90 +- 2),?? (normal value 85 +- 2),??? normal values 20 +- 2) and TTratio? normal values: 27% to 42%). Results: The study included 31 ankles of TM Ankle Replacement in 31 consecutive patients over a period of 2 years (2013–2015). Out of 31 patients, 13 were females and 18 were males (average age 49.4 years, range, 30–75 years). All procedures were performed by a single surgeon. The ROM plantarflexion and dorsiflexion improved significantly (p <0.001) at the last follow up. The mean VAS pain score decreased significantly from 7.42 points (range 4 – 10 points) preoperatively to 1.42 points (range, 0 - 3 points) at the time of the latest follow-up (p <0.001). AOFAS and SF-12 scores both improved from postoperatively to the last follow up. (Table 1). We noted stable implants based on our radiographic parameters, with no corrections loosening. (Table 2) Conclusion: Our study evaluated the new fixed bearing Zimmer TM total ankle replacement approved by the US FDA in 2012 and is the first studies to evaluate the clinical and radiographic outcomes of this prosthesis. Of 31 ankles treated with a new transfibular arthroplasty system, only two asymptomatic fibular delayed union were registered. No implant failure was noted at 24 months postoperatively. Four ankles underwent secondary surgery for symptomatic fibular hardware with good outcome. The findings suggest that this total ankle system is safe and effective at short-term follow-up.

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