Optimization of parameters for femoral component implantation during TKA using finite element analysis and orthogonal array testing

Zhifang Mou,Aohan Wang,Zhen Zhang,Guanghong Hu,Yuefu Dong,Wanpeng Dong,Bing Wang

doi:10.1186/s13018-018-0891-1

Abstract

BackgroundIndividualized and accurate implantation of a femoral component during total knee arthroplasty (TKA) is essential in achieving equal distribution of intra-articular stress and long-term survival of the prosthesis. However, individualized component implantation remains challenging. This study aimed to optimize and individualize the positioning parameters of a femoral component in order to facilitate its accurate implantation.MethodsUsing computer-simulated TKA, the positioning parameters of a femoral component were optimized individually by finite element analysis in combination with orthogonal array testing. Flexion angle, valgus angle, and external rotation angle were optimized in order to reduce the peak value of the pressure on the polyethylene liner of the prosthesis.ResultsThe optimal implantation parameters of the femoral component were as follows: 1° flexion, 5° valgus angle, and 4° external rotation. Under these conditions, the peak value of the pressure on the polyethylene liner surface was minimized to 16.46 MPa. Among the three parameters, the external rotation angle had the greatest effect on the pressure, followed by the valgus angle and the flexion angle.ConclusionFinite element analysis in combination with orthogonal array testing can optimize the implantation parameters of a femoral component for TKA. This approach would possibly reduce the wear of the polyethylene liner and prolong the survival of the TKA prosthesis, due to its capacity to minimize stress. This technique represents a new method for preoperative optimization of the implantation parameters that can achieve the best possible TKA outcome.

Highlights

Individualized and accurate implantation of a femoral component during total knee arthroplasty (TKA) is essential in achieving equal distribution of intra-articular stress and long-term survival of the prosthesis
Computer-navigated Total knee arthroplasty (TKA) can improve the accuracy of TKA prosthesis implantation and achieve a postoperative lower limb mechanical axis that is closer to the ideal position [20, 21]
The main objectives of our study were (1) to determine whether finite element analysis in combination with orthogonal array testing could be used to reduce the stress on the polyethylene liner, (2) to obtain the ideal optimization, and (3) to establish which implantation parameter had the most influence on stress distribution

Summary

Introduction

Individualized and accurate implantation of a femoral component during total knee arthroplasty (TKA) is essential in achieving equal distribution of intra-articular stress and long-term survival of the prosthesis. Accurate implantation of an individualized TKA prosthesis could effectively reduce the surgical error and avoid the uneven distribution of the intra-articular load, thereby stabilizing the knee joint, reducing prosthetic loosening, and improving knee function [15,16,17,18]. A preoperative plan that is based on the anatomic features of a patient can aid the restoration of the neutral mechanical axis of the lower extremity, it cannot directly reveal the distribution of intra-articular stress and/or reliably predict the survival of the TKA prosthesis

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