Ma Jianbing, Xu Chao, Zhao Guanghui, Xiao Lin, Wang Jianpeng
Department of Joint Surgery, Honghui Hospital, Xi'An Jiaotong University, No. 555 East Youyi Road, Xi'an, Shanxi, China.
Heliyon. 2023 Feb 28;9(3):e14182. doi: 10.1016/j.heliyon.2023.e14182. eCollection 2023 Mar.
Cement can be reinforced with cancellous screws for repairing tibial defect in total knee arthroplasty (TKA). However, it is still unknown which size (diameter, length) of screws is better, and the purpose of this study was to perform a finite element analysis (FEA) to determine it. Twelve FEA models were set to represent the cement-screw technique with different diameters (3.5 mm, 5 mm and 6.5 mm) and lengths (20 mm, 25 mm, 30 mm and 35 mm). Contact stresses on the surface of cancellous bone in different areas were calculated. Compared to screws with diameter of 3.5 mm, stresses on the surface of bone defect reduced 5.75% of 5 mm and 10.68% of 6.5 mm for the screw length of 20 mm, 4.23% of 5 mm and 9.16% of 6.5 mm for 25 mm, 6.65% of 5 mm and 12.30% of 6.5 mm for 30 mm, and 5.05% of 5 mm and 12.16% of 6.5 mm for 35 mm. Compared to screws with diameter of 5 mm, stresses on the surface of defect reduced 5.24%, 5.15%, 6.05%, and 7.49% of 6.5 mm for the screw length of 20, 25, 30, and 35 mm. However, it did not show any significant difference in other comparisons. For the treatment of tibial defect in TKA with cement-screw technique, longer screw may not achieve better stability, but the thicker screw can reduce more stresses on the surface of tibial defect and achieve better stability. However, the depth of bone defect must be considered when making a choice.
在全膝关节置换术（TKA）中，骨水泥可用松质骨螺钉加强以修复胫骨缺损。然而，哪种尺寸（直径、长度）的螺钉更佳仍不明确，本研究的目的是进行有限元分析（FEA）以确定这一点。设置了12个有限元模型来代表采用不同直径（3.5毫米、5毫米和6.5毫米）和长度（20毫米、25毫米、30毫米和35毫米）的骨水泥 - 螺钉技术。计算了不同区域松质骨表面的接触应力。与直径3.5毫米的螺钉相比，对于20毫米长的螺钉，骨缺损表面应力在5毫米直径螺钉时降低了5.75%，在6.5毫米直径螺钉时降低了10.68%；对于25毫米长的螺钉，5毫米直径螺钉时降低了4.23%，6.5毫米直径螺钉时降低了9.16%；对于30毫米长的螺钉，5毫米直径螺钉时降低了6.65%，6.5毫米直径螺钉时降低了12.30%；对于35毫米长的螺钉，5毫米直径螺钉时降低了5.05%，6.5毫米直径螺钉时降低了12.16%。与直径5毫米的螺钉相比，对于20、25、30和35毫米长的螺钉，6.5毫米直径螺钉时骨缺损表面应力分别降低了5.24%、5.15%、6.05%和7.49%。然而，在其他比较中未显示出任何显著差异。对于采用骨水泥 - 螺钉技术治疗TKA中的胫骨缺损，较长的螺钉可能无法获得更好的稳定性，但较粗的螺钉可减少胫骨缺损表面更多的应力并获得更好的稳定性。然而，选择时必须考虑骨缺损的深度。
