Abstract
Background. This study aims to analyze the tibial component using the finite element method by cutting the tibial in frontal and sagittal planes at an angle between 1.5° (valgus and anterior tilt) and -1.5° (varus and posterior tilt). Methods. This experimental study used the finite element method as an useful tool for simulating the positioning of the tibial component in order to create a personal pre-operative planning. For the finite element method analysis, a geometrical model of a tibia from a cadaver was three – dimensionally scanned and the tibial component, polyethylene and cement, were three-dimensionally shaped in Computer-Aided Design program using material data such as Young modulus (gigapascal – GPa) and the Poisson coefficient. The analysis determined the equivalent von Mises stress, the maximum displacement of the components and the equivalent von Mises deformation. The results showed that equivalent tension and deformation have higher values in the tibia and the polyethylene, which deform faster than cement and the tibial component. In our study, we chose to simulate the tibial resection at a cutting angle ± 1.5° from neutral positioning (which is represented in frontal plane by the perpendicular on the mechanical axis and in sagittal plane by the posterior slope of 7 degree) in frontal and sagittal plane in order to find the minimum threshold from which the tibial component malalignment may begin to determine unfavorable effects. Results. Our results have shown detrimental effects begin to appear for the polyethene component at -1.5° in frontal plane, and the rest of the components at 1.5° in sagittal plane. Conclusion. This finding leads us to propose preoperative planning based on personal calculus of predefined angles, which may show the surgeon the optimal implantation position of the tibial component.
Highlights
Total knee arthroplasty (TKA) is the most frequently used and effective treatment for advanced knee osteoarthritis
The last phase shows graphically results of the analysis, which determines equivalent von Mises tension, maximum displacement of components, and equivalent von Mises deformation. In both the frontal and sagittal plane, the proximal tibial cut was made at a 1.5° and at -1.5°, and finite element analysis were made at these values
Proximal tibial cut at 1.5° - frontal plane Proximal tibial cut at 1.5° - frontal plane Proximal tibial cut at 1.5° - sagittal plane Proximal tibial cut at -1.5° - sagittal plane MPa – megapascal
Summary
Total knee arthroplasty (TKA) is the most frequently used and effective treatment for advanced knee osteoarthritis. Literature data frequently describe effects of sagittal or coronal alignment, implying that component malpositioning has been associated with pain, accelerated polyethylene wear, joint instability, and eventually to TKA revision [4]. The. This study aims to analyse the tibial component using the finite element method by cutting the tibial in frontal and sagittal planes at an angle between 1.5° (valgus and anterior tilt) and -1.5° (varus and posterior tilt). This experimental study used the finite element method as an useful tool for simulating the positioning of the tibial component in order to create a personal pre-operative planning. For the finite element method analysis, a geometrical model of a tibia from a cadaver was three – dimensionally scanned and the tibial component, polyethylene and cement, were three-dimensionally shaped in Computer-Aided Design program using material data such as Young modulus (gigapascal – GPa) and the Poisson coefficient. This finding leads us to propose preoperative planning based on personal calculus of predefined angles, which may show the surgeon the optimal implantation position of the tibial component
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