State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China.
Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), School of Mechanical Engineering, Chang'an University, Xi'an, Shaanxi, China.
Comput Methods Programs Biomed. 2022 Aug;223:106976. doi: 10.1016/j.cmpb.2022.106976. Epub 2022 Jun 27.
Loosening and wear are still the main problems for the failure of total ankle arthroplasty, which are closely related to the micromotion at the bone-implant interface and the contact stress and joint motions at the articular surfaces. Implant design is a key factor to influence the ankle force, motions, contact stress, and bone-implant interface micromotion. The purpose of this study is to evaluate the differences in these parameters of INBONE II, INFINITY, and a new anatomic ankle implant under the physiological walking gait of three patients.
This was achieved by using an in-silico simulation framework combining patient-specific musculoskeletal multibody dynamics and finite element analysis. Each implant was implanted into the musculoskeletal multibody dynamics model, respectively, which was driven by the gait data to calculate ankle forces and motions. These were then used as the boundary conditions for the finite element model, and the contact stress and the bone-implant interface micromotions were calculated.
The total ankle contact forces were not significantly affected by articular surface geometries of ankle implants. The range of motion of the ankle joint implanted with INFINITY was a little larger than that with INBONE II. The anatomic ankle implant design produced a greater range of motion than INBONE II, especially the internal-external rotation. The fixation design of INFINITY achieved lower bone-implant interface micromotion compared with INBONE II. The anatomic ankle implant design produced smaller contact stress with no evident edge contact and a smaller tibia-implant interface micromotion. In addition, significant differences in the magnitudes and tendencies of total ankle contact forces and motions among different patients were found.
The articular surface geometry of ankle implants not only affected the ankle motions and contact stress distribution but also affected the bone-implant interface micromotions. The anatomic ankle implant had good performance in recovering ankle joint motion, equalizing contact stress, and reducing bone-implant interface micromotion. INFINITY's fixation design could achieve smaller bone-implant interface micromotion than INBONE II.
松动和磨损仍然是全踝关节置换失败的主要问题，这与骨-假体界面的微动以及关节表面的接触应力和关节运动密切相关。植入物设计是影响踝关节力、运动、接触应力和骨-假体界面微动的关键因素。本研究的目的是评估三位患者生理步态下 INBONE II、INFINITY 和一种新型解剖型踝关节植入物的这些参数差异。
这是通过使用结合患者特定肌肉骨骼多体动力学和有限元分析的仿真框架来实现的。分别将每个植入物植入肌肉骨骼多体动力学模型中，由步态数据驱动以计算踝关节力和运动。然后将这些作为有限元模型的边界条件，计算接触应力和骨-假体界面微动。
踝关节假体的关节面几何形状对踝关节总接触力没有显著影响。植入 INFINITY 的踝关节活动范围略大于植入 INBONE II 的踝关节。解剖型踝关节植入物设计产生的运动范围大于 INBONE II，尤其是内外旋转。与 INBONE II 相比，INFINITY 的固定设计产生的骨-假体界面微动更小。解剖型踝关节植入物设计产生的接触应力更小，没有明显的边缘接触，胫骨-植入物界面微动也更小。此外，不同患者的总踝关节接触力和运动的大小和趋势存在显著差异。
踝关节假体的关节面几何形状不仅影响踝关节运动和接触应力分布，还影响骨-假体界面微动。解剖型踝关节植入物在恢复踝关节运动、均衡接触应力和减少骨-假体界面微动方面表现良好。INFINITY 的固定设计可实现比 INBONE II 更小的骨-假体界面微动。
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