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全踝关节置换胫骨假体固定设计对骨-假体界面生物力学性能影响的有限元分析。

Finite-element analysis of the influence of tibial implant fixation design of total ankle replacement on bone-implant interfacial biomechanical performance.

机构信息

Department of Orthopedics, 159397Huashan Hospital, Fudan University, Shanghai, China.

Academy for Engineering and Technology, 12478Fudan University, Shanghai, China.

出版信息

J Orthop Surg (Hong Kong). 2020 Sep-Dec;28(3):2309499020966125. doi: 10.1177/2309499020966125.


DOI:10.1177/2309499020966125
PMID:33155519
Abstract

PURPOSE: Implant loosening in tibia after primary total ankle replacement (TAR) is one of the common postoperative problems in TAR. Innovations in implant structure design may ideally reduce micromotion at the bone-implant interface and enhance the bone-implant fixation and initial stability, thus eventually prevents long-term implant loosening. This study aimed to investigate (1) biomechanical characteristics at the bone-implant interface and (2) the influence of design features, such as radius, height, and length. METHODS: A total of 101 finite-element models were created based on four commercially available implants. The models predicted micromotion at the bone-implant interface, and we investigated the impact of structural parameters, such as radius, length, and height. RESULTS: Our results suggested that stem-type implants generally required the highest volume of bone resection before implantation, while peg-type implants required the lowest. Compared with central fixation features (stem and keel), peripherally distributed geometries (bar and peg) were associated with lower initial micromotions. The initial stability of all types of implant design can be optimized by decreasing fixation size, such as reducing the radius of the bars and pegs and lowering the height. CONCLUSION: Peg-type tibial implant design may be a promising fixation method, which is required with a minimum bone resection volume and yielded minimum micromotion under an extreme axial loading scenario. Present models can serve as a useful platform to build upon to help physicians or engineers when making incremental improvements related to implant design.

摘要

目的:初次全踝关节置换(TAR)后胫骨内植物松动是 TAR 术后常见的问题之一。植入物结构设计的创新可以理想地减少骨-植入物界面的微动,并增强骨-植入物固定和初始稳定性,从而最终防止长期植入物松动。本研究旨在研究(1)骨-植入物界面的生物力学特性,(2)设计特征(如半径、高度和长度)的影响。 方法:基于四种商业上可用的植入物,共创建了 101 个有限元模型。这些模型预测了骨-植入物界面的微动,并研究了结构参数(如半径、长度和高度)的影响。 结果:我们的结果表明,在植入前,柄式植入物通常需要切除最大体积的骨,而钉式植入物需要切除的最少。与中央固定特征(柄和龙骨)相比,外周分布的几何形状(杆和钉)与较低的初始微动相关。所有类型的植入物设计的初始稳定性都可以通过减小固定尺寸来优化,例如减小杆和钉的半径以及降低高度。 结论:钉式胫骨植入物设计可能是一种有前途的固定方法,它需要切除最小体积的骨,并在极端轴向加载情况下产生最小的微动。目前的模型可以作为一个有用的平台,帮助医生或工程师在相关植入物设计方面进行渐进式改进。

相似文献

[1]
Finite-element analysis of the influence of tibial implant fixation design of total ankle replacement on bone-implant interfacial biomechanical performance.

J Orthop Surg (Hong Kong). 2020

[2]
A combined FE-hybrid MCDM framework for improving the performance of the conical stem tibial design for TAR with the addition of pegs.

Comput Methods Programs Biomed. 2023-7

[3]
Total ankle replacement design and positioning affect implant-bone micromotion and bone strains.

Med Eng Phys. 2017-4

[4]
Biomechanical evaluation of total ankle arthroplasty. Part II: Influence of loading and fixation design on tibial bone-implant interaction.

J Orthop Res. 2021-1

[5]
Do Metaphyseal Cones and Stems Provide Any Biomechanical Advantage for Moderate Contained Tibial Defects in Revision TKA? A Finite-Element Analysis Based on a Cadaver Model.

Clin Orthop Relat Res. 2021-11-1

[6]
Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study.

J Orthop Res. 2024-7

[7]
Malalignment of the total ankle replacement increases peak contact stresses on the bone-implant interface: a finite element analysis.

BMC Musculoskelet Disord. 2022-5-17

[8]
Influence of Tibial Component Design Features and Interference Fit on Implant-Bone Micromotion in Total Ankle Replacement: A Finite Element Study.

Foot Ankle Int. 2024-12

[9]
Comparison of joint load, motions and contact stress and bone-implant interface micromotion of three implant designs for total ankle arthroplasty.

Comput Methods Programs Biomed. 2022-8

[10]
The role of the depth of resection of the distal tibia on biomechanical performance of the tibial component for TAR: A finite element analysis with three implant designs.

Med Eng Phys. 2023-9

引用本文的文献

[1]
Statistical shape modeling of shape variability of the human distal tibia: implication for implant design of the tibial component for total ankle replacement.

Front Bioeng Biotechnol. 2025-2-27

[2]
Influence of different fixation modes on biomechanical conduction of 3D printed prostheses for treating critical diaphyseal defects of lower limbs: A finite element study.

Front Surg. 2022-8-24

[3]
Malalignment of the total ankle replacement increases peak contact stresses on the bone-implant interface: a finite element analysis.

BMC Musculoskelet Disord. 2022-5-17

[4]
Finite element stress analysis of the bearing component and bone resected surfaces for total ankle replacement with different implant material combinations.

BMC Musculoskelet Disord. 2022-1-19

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