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Total ankle replacement design and positioning affect implant-bone micromotion and bone strains.

作者信息

Sopher Ran S, Amis Andrew A, Calder James D, Jeffers Jonathan R T

机构信息

Department of Mechanical Engineering, Imperial College London, 715 City & Guilds Building, South Kensington, London SW7 2AZ, UK.

Department of Mechanical Engineering, Imperial College London, 715 City & Guilds Building, South Kensington, London SW7 2AZ, UK ; Department of Surgery & Cancer, Imperial College London, Charing Cross Hospital, London, W6 8RP, UK.

出版信息

Med Eng Phys. 2017 Apr;42:80-90. doi: 10.1016/j.medengphy.2017.01.022. Epub 2017 Feb 21.


DOI:10.1016/j.medengphy.2017.01.022
PMID:28233732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5360194/
Abstract

Implant loosening - commonly linked with elevated initial micromotion - is the primary indication for total ankle replacement (TAR) revision. Finite element modelling has not been used to assess micromotion of TAR implants; additionally, the biomechanical consequences of TAR malpositioning - previously linked with higher failure rates - remain unexplored. The aim of this study was to estimate implant-bone micromotion and peri-implant bone strains for optimally positioned and malpositioned TAR prostheses, and thereby identify fixation features and malpositioning scenarios increasing the risk of loosening. Finite element models simulating three of the most commonly used TAR devices (BOX, Mobility and Salto) implanted into the tibia/talus and subjected to physiological loads were developed. Mobility and Salto demonstrated the largest micromotion of all tibial and talar components, respectively. Any malpositioning of the implant creating a gap between it and the bone resulted in a considerable increase in micromotion and bone strains. It was concluded that better primary stability can be achieved through fixation nearer to the joint line and/or while relying on more than a single peg. Incomplete seating on the bone may result in considerably elevated implant-bone micromotion and bone strains, thereby increasing the risk for TAR failure.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/ecb562920039/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/c328791da968/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/584d338578a4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/9f8748ceec84/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/15b560430a4c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/1243530f454a/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/051abd97c48d/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/7973294f770f/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/c5c44f24692b/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/e5099ec2d3de/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/ecb562920039/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/c328791da968/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/584d338578a4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/9f8748ceec84/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/15b560430a4c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/1243530f454a/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/051abd97c48d/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/7973294f770f/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/c5c44f24692b/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/e5099ec2d3de/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8290/5360194/ecb562920039/gr10.jpg

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引用本文的文献

[1]
[Effects of elastic modulus of the metal block on the condylar-constrained knee prosthesis tibial fixation stability].

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025-8-25

[2]
[Biomechanical effects of medial and lateral translation deviations of femoral components in unicompartmental knee arthroplasty on tibial prosthesis fixation].

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025-2-25

[3]
[Biomechanical study of three-dimensional printed filler block design in open wedge high tibial osteotomy].

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2024-8-25

[4]
An evaluation of the total ankle replacement in the modern era: a narrative review.

Ann Transl Med. 2024-8-1

[5]
Effect of novel polyethylene insert configurations on bone-implant micromotion and contact stresses in total ankle replacement prostheses: a finite element analysis.

Front Bioeng Biotechnol. 2024-4-18

[6]
A macro-micro FE and ANN framework to assess site-specific bone ingrowth around the porous beaded-coated implant: an example with BOX® tibial implant for total ankle replacement.

Med Biol Eng Comput. 2024-6

[7]
The novel magnesium-titanium hybrid cannulated screws for the treatment of vertical femoral neck fractures: Biomechanical evaluation.

J Orthop Translat. 2023-9-2

[8]
Patient-Reported Outcomes in Total Ankle Arthroplasty: Patient Specific Versus Standard Instrumentation.

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[9]
A Novel Method for Preoperative Positioning of Total Ankle Replacement Using 3D Digital Model.

Orthop Surg. 2022-7

[10]
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本文引用的文献

[1]
The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint.

J Strain Anal Eng Des. 2017-1

[2]
Digital volume correlation and micro-CT: An in-vitro technique for measuring full-field interface micromotion around polyethylene implants.

J Biomech. 2015-9-18

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Effect of Coronal and Sagittal Alignment on Outcome After Mobile-Bearing Total Ankle Replacement.

Foot Ankle Int. 2015-9

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J Bone Joint Surg Am. 2014-9-3

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Prediction of structural failure of tibial bone models under physiological loads: effect of CT density-modulus relationships.

Med Eng Phys. 2014-8

[6]
Development and experimental validation of a finite element model of total ankle replacement.

J Biomech. 2013-12-24

[7]
Development and validation of a numerical model for tibial component analysis in total ankle replacement.

Comput Methods Biomech Biomed Engin. 2013

[8]
Early prospective clinical results of a modern fixed-bearing total ankle arthroplasty.

J Bone Joint Surg Am. 2013-6-5

[9]
Validation of multiple subject-specific finite element models of unicompartmental knee replacement.

Med Eng Phys. 2013-5-3

[10]
Longitudinal migration and inducible displacement of the Mobility Total Ankle System.

Acta Orthop. 2012-8-10

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