Abstract
This paper aimed to evaluate the biomechanical effects of tibial bearing materials, from ultra-high-molecular-weight polyethylene (UHMWPE) to poly-ether-ether-ketone (PEEK) and carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK). The studies were conducted based on a validated finite element model. The geometry of the intact knee model was developed from computed tomography and magnetic resonance imaging of the left knee joint of a 37-year-old healthy male volunteer. Three different loading conditions, related to the loads applied in the experimental research, were applied to this study for model predictions and validation. The contact stress in the other compartments was under normal walking conditions. Also, stresses on five regions of the tibia bone were analyzed under normal walking conditions. The lowest contact stress between the lateral meniscus and tibial cartilage was achieved in the order of the use of CFR-PEEK, PEEK, and UHMWPE tibial bearings. Moreover, CFR-PEEK and PEEK tibial bearings indicated lower and greater stresses on cortical and trabecular bones, respectively, compared to the UHMWPE tibial bearing. These results show that CFR-PEEK can be used as a tibial bearing material as an alternative to UHMWPE, and such a change in the material may be a good method for reducing potential anteromedial pain.
Highlights
Uni-compartmental knee arthroplasty (UKA) has recently become a popular procedure owing to its excellent treatment of anteromedial osteoarthritis (OA), for focal defect treatment in younger patients and in those with early localized OA of the knee [1,2,3]
The finite element (FE) model was subjected to evaluations based on experimental data available in the FE model wasconducted subjected to experimental data available in the literature
We found that the lowest contact stress occurred on the lateral meniscus and tibial cartilage when important
Summary
Uni-compartmental knee arthroplasty (UKA) has recently become a popular procedure owing to its excellent treatment of anteromedial osteoarthritis (OA), for focal defect treatment in younger patients and in those with early localized OA of the knee [1,2,3]. several clinical studies have reported that UKA can mimic the motion of an intact knee [4,5], and some authors have shown outstanding results over 10 years of follow-up with up-to-date designs [1,6], failures with this procedure have been reported [7,8]. The clinical outcomes of UKA have shown four main postoperative problems: malpositioning of the prosthetic parts, tibial bearing wear, OA progression in the remaining compartments, and localized tibia bone stress [7,8,9,10]. Because of the recently strict selection of patients and advanced surgical techniques, the long-term survival rate post-UKA has been significantly enhanced [3]. In both types, fixed and mobile bearings, the wear of tibial bearings made from ultra-high-molecular-weight polyethylene (UHMWPE) is an important issue in the long-term.
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