Zheng Zhiqian, Liu Yang, Zhang Aobo, Chen Hao, Wan Qian, Zhong Lei, Wang Xiaonan, Han Qing, Wang Jincheng
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China.
Front Bioeng Biotechnol. 2023 Mar 2;11:1119204. doi: 10.3389/fbioe.2023.1119204. eCollection 2023.
Poor prosthesis alignment during total knee arthroplasty could cause problems such as polyethylene spacer wear, leading to surgical failure and revision surgery. The problems caused by the malalignment of the tibial plateau prosthesis in the medial and lateral planes are unclear. We aimed to investigate the stress distribution and micromotion of the tibia when the tibial plateau prosthesis is translated 1 and 2 mm medially and laterally, respectively, using finite element analysis (FEA). A non-homogeneous tibia model was created and load conditions when standing on two legs were applied using FEA to simulate the misaligned prosthesis. The stresses, stress distribution, and micromotion of the proximal tibia were analyzed in five positions of the tibial plateau prosthesis: Lateral-2 mm; Lateral-1 mm; Medium; Medial-2 mm; Medial-1 mm. The maximum stress in the five groups with different misalignments of the platform was 47.29 MPa (Lateral-2 mm). The maximum micromotion among the five groups in different positions was 7.215 μm (Lateral-2 mm). When placing the tibial plateau prosthesis during total knee arthroplasty, an error of 2 mm or less is acceptable as long as it does not overhang.
全膝关节置换术中假体对线不良可能会导致诸如聚乙烯垫片磨损等问题，进而导致手术失败和翻修手术。胫骨平台假体在内侧和外侧平面排列不齐所引起的问题尚不清楚。我们旨在通过有限元分析（FEA）研究当胫骨平台假体分别向内侧和外侧平移1毫米和2毫米时胫骨的应力分布和微动情况。创建了一个非均质胫骨模型，并使用有限元分析施加双腿站立时的负荷条件以模拟排列不齐的假体。在胫骨平台假体的五个位置分析了胫骨近端的应力、应力分布和微动情况：外侧-2毫米；外侧-1毫米；正中；内侧-2毫米；内侧-1毫米。平台不同排列不齐的五组中的最大应力为47.29兆帕（外侧-2毫米）。不同位置的五组中的最大微动为7.215微米（外侧-2毫米）。在全膝关节置换术中放置胫骨平台假体时，只要不出现悬垂，2毫米或更小的误差是可以接受的。
