Montgomery Liam, Willing Ryan, Lanting Brent
School of Biomedical Engineering, University of Western Ontario, London, ON N6A 3K7, Canada.
Department of Mechanical and Materials Engineering, University of Western Ontario, London, ON N6A 3K7, Canada.
Bioengineering (Basel). 2023 Apr 22;10(5):503. doi: 10.3390/bioengineering10050503.
Component alignment accuracy during total knee arthroplasty (TKA) has been improving through the adoption of image-based navigation and robotic surgical systems. The biomechanical implications of resulting component alignment error, however, should be better characterized to better understand how sensitive surgical outcomes are to alignment error. Thus, means for analyzing the relationships between alignment, joint kinematics, and ligament mechanics for candidate prosthesis component design are necessary. We used a digital twin of a commercially available joint motion simulator to evaluate the effects of femoral component rotational alignment. As anticipated, the model showed that an externally rotated femoral component results in a knee which is more varus in flexion, with lower medial collateral ligament tension compared to a TKA knee with a neutrally aligned femoral implant. With the simulation yielding logical results for this relatively simple test scenario, we can have more confidence in the accuracy of its predictions for more complicated scenarios.
通过采用基于图像的导航和机器人手术系统，全膝关节置换术（TKA）期间的组件对准精度一直在提高。然而，由此产生的组件对准误差的生物力学影响应得到更好的表征，以便更好地了解手术结果对对准误差的敏感程度。因此，有必要分析候选假体组件设计的对准、关节运动学和韧带力学之间的关系。我们使用了一个市售关节运动模拟器的数字孪生模型来评估股骨组件旋转对准的影响。正如预期的那样，该模型表明，与股骨植入物中立对准的TKA膝关节相比，股骨组件向外旋转会导致膝关节在屈曲时更加内翻，内侧副韧带张力更低。由于该模拟在这个相对简单的测试场景中产生了合乎逻辑的结果，我们可以对其在更复杂场景下预测的准确性更有信心。
