Abstract
BackgroundArticular surface curvature design is important in tibiofemoral kinematics and the contact mechanics of total knee arthroplasty (TKA). Thus far, the effects of articular surface curvature have not been adequately discussed with respect to conforming, nonconforming, and medial pivot designs in patient-specific TKA. Therefore, this study evaluates the underlying relationship between the articular surface curvature geometry and the wear performance in patient-specific TKA.MethodsWe compare the wear performances between conventional and patient-specific TKA under gait loading conditions using a computational simulation. Patient-specific TKAs investigated in the study are categorized into patient-specific TKA with conforming articular surfaces, medial pivot patient-specific TKA, and bio-mimetic patient-specific TKA with a patient’s own tibial and femoral anatomy. The geometries of the femoral components in patient-specific TKAs are identical.ResultsThe anterior-posterior and internal-external kinematics change with respect to different TKA designs. Moreover, the contact pressure and area did not directly affect the wear performance. In particular, conforming patient-specific TKAs exhibit the highest volumetric wear and wear rate. The volumetric wear in a conforming patient-specific TKA is 29% greater than that in a medial pivot patient-specific TKA.ConclusionThe findings in this study highlight that conformity changes in the femoral and tibial inserts influence the wear performance in patient-specific TKA. Kinematics and contact parameters should be considered to improve wear performance in patient-specific TKA. The conformity modification in the tibiofemoral joint changes the kinematics and contact parameters, and this affects wear performance.
Highlights
Total knee arthroplasty (TKA) is considered an extremely effective treatment procedure for knee pain associated with degenerative joint disease [1,2,3]
We recently studied the changes of the kinematics and wear with respect to different conformities of the articular surface of posterior-stabilized (PS) total knee arthroplasty (TKA) designs [18]
We evaluate the wear performances of four different TKAs as follows: conventional Genesis II TKA, patientspecific TKA with Genesis II conformity (CPS-TKA), patient-specific TKA with medial pivot conformity (MPS-TKA), and bio-mimetic patient-specific TKA with a patient’s own tibial and femoral anatomy (BPS-TKA)
Summary
Total knee arthroplasty (TKA) is considered an extremely effective treatment procedure for knee pain associated with degenerative joint disease [1,2,3]. Changing demographics and higher expectations for TKA increase the demands for effective surgical techniques and implant designs. To address the aforementioned issues, a few studies have proposed an anatomical approach to TKA by using patient-specific or customized prostheses. Patient-specific TKA attempts to preserve a patient’s anatomical geometry. Articular surface curvature design is important in tibiofemoral kinematics and the contact mechanics of total knee arthroplasty (TKA). The effects of articular surface curvature have not been adequately discussed with respect to conforming, nonconforming, and medial pivot designs in patient-specific TKA.
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