Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea.
Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea.
Knee. 2020 Oct;27(5):1484-1491. doi: 10.1016/j.knee.2020.08.001. Epub 2020 Aug 23.
Localized cartilage defects are related to joint pain and reduced function to the development of osteoarthritis. The mechanical properties of the implant for treatment do influence its longevity. Therefore, we aimed to evaluate the effect of material properties' variations of anatomically shaped focal knee implants in the knee joint using numerical finite element analysis.
Computational simulations were performed for different cases including an intact knee, a knee with a focal cartilage defect, and a knee fitted with a focal articular prosthetic having three distinct mechanical properties: cobalt-chromium, pyrolytic carbon, and polyethylene. Femoral cartilage, tibial cartilage, and menisci contact pressures were evaluated under the load. In addition, bone stress was evaluated to investigate the stress shielding effect.
Compared with the intact model, the contact stress of the focal implant model was increased; on the femoral lateral cartilage by 14%, on medial and lateral tibial cartilages by nine percent and 10%, on medial and lateral menisci by 23% and 20%. In contrast, the focal implant model had no effect on the menisci but contact stress on the tibial cartilage increased compared with the intact model. The BioPoly model showed the lowest contact stress on femoral and tibial cartilages. Additionally, the cobalt-chromium model showed the lowest bone stress that improved the load-sharing effect.
The results suggested that implant material properties are an important parameter in the design of a focal implant. The polyethylene model potentially restored the intact knee contact mechanics and it reduced the risk of physiological damage to the articular cartilage.
局部软骨缺损与关节疼痛和功能下降有关,进而发展为骨关节炎。治疗用植入物的力学性能确实会影响其使用寿命。因此,我们旨在使用数值有限元分析评估解剖形状的膝关节局部植入物的材料性能变化对膝关节的影响。
对不同情况进行了计算模拟,包括完整的膝关节、有局部软骨缺损的膝关节和装有三个不同机械性能的局部关节假体的膝关节:钴铬、热解碳和聚乙烯。在负荷下评估了股骨软骨、胫骨软骨和半月板的接触压力。此外,评估了骨应力以研究应力遮挡效应。
与完整模型相比,局部植入物模型的接触压力增加;在股骨外侧软骨增加了 14%,在内外侧胫骨软骨增加了 9%和 10%,在内外侧半月板增加了 23%和 20%。相比之下,局部植入物模型对半月板没有影响,但与完整模型相比,胫骨软骨的接触压力增加。BioPoly 模型在股骨和胫骨软骨上显示出最低的接触压力。此外,钴铬模型显示出最低的骨应力,改善了负荷分担效应。
结果表明,植入物材料性能是局部植入物设计的一个重要参数。聚乙烯模型可能恢复了完整膝关节的接触力学,降低了对关节软骨的生理损伤风险。