Mou Zhifang, Dong Wanpeng, Zhang Zhen, Wang Aohan, Hu Guanghong, Wang Bing, Dong Yuefu
Department of Critical Care Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University/the First People's Hospital of Lianyungang, Lianyungang, China.
School of Materials Engineering, Shanghai University of Engineering Science, Shanghai, China.
J Orthop Surg Res. 2018 Jul 20;13(1):179. doi: 10.1186/s13018-018-0891-1.
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. 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.
Using 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.
The 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.
Finite 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.
全膝关节置换术（TKA）中股骨组件的个体化和精确植入对于实现关节内应力的均匀分布和假体的长期存活至关重要。然而，组件的个体化植入仍然具有挑战性。本研究旨在优化股骨组件的定位参数并使其个体化，以促进其精确植入。
使用计算机模拟的TKA，通过有限元分析结合正交试验对股骨组件的定位参数进行个体化优化。为降低假体聚乙烯衬垫上的压力峰值，对屈曲角度、外翻角度和外旋角度进行了优化。
股骨组件的最佳植入参数如下：屈曲1°、外翻角度5°、外旋角度4°。在这些条件下，聚乙烯衬垫表面的压力峰值最小化至16.46MPa。在这三个参数中，外旋角度对压力的影响最大，其次是外翻角度和屈曲角度。
有限元分析结合正交试验可优化TKA股骨组件的植入参数。由于其能够将应力降至最低，这种方法可能会减少聚乙烯衬垫的磨损并延长TKA假体的使用寿命。该技术代表了一种术前优化植入参数的新方法，可实现最佳的TKA效果。
