Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China.
J Orthop Surg (Hong Kong). 2024 May-Aug;32(2):10225536241251926. doi: 10.1177/10225536241251926.
To explore the effects of tibial osteotomy varus angle combined with posterior tibial slope (PTS) on the stress of polyethylene liner in total knee arthroplasty (TKA) by building finite element model (FEM).
Established the FEM of standard TKA with tibial osteotomy varus angle 0° to 9° were established and divided into 10 groups. Next, each group was created 10 FEMs with 0° to 9° PTS separately. Calculated the stress on polyethylene liner in each group in Abaqus. Finally, the relevancy between tibial osteotomy angle and polyethylene liner stress was statistically analyzed using multiple regression analysis.
As the varus angle increased, the area of maximum stress gradually shifted medially on the polyethylene liner. As the PTS increases, the percentage of surface contact forces on the medial and lateral compartmental of the polyethylene liner gradually converge to the same. When the varus angle is between 0° and 3°, the maximum stress of the medial compartmental surfaces of polyethylene liner rises smoothly with the increase of the PTS. When the varus angle is between 4° and 9°, as the increase of the PTS, the maximum stress of polyethylene liner rises first and then falls, forming a trough at PTS 5° and then rises again. Compared to the PTS, the varus angle has a large effect on the maximum stress of the polyethylene liner ( < .001).
When the varus angle is 0° to 3°, PTS 0° is recommended, which will result in a more equalized stress distribution of the polyethylene liner in TKA.
通过建立有限元模型（FEM），探讨胫骨截骨内翻角度与胫骨后倾角（PTS）对全膝关节置换术（TKA）中聚乙烯衬垫应力的影响。
建立胫骨截骨内翻角度为 0°至 9°的标准 TKA 的 FEM，并将其分为 10 组。然后，为每组分别建立 0°至 9° PTS 的 10 个 FEM。在 Abaqus 中计算每组聚乙烯衬垫的应力。最后，采用多元回归分析对胫骨截骨角度与聚乙烯衬垫应力之间的相关性进行统计学分析。
随着内翻角度的增加，聚乙烯衬垫上的最大应力区域逐渐向内侧转移。随着 PTS 的增加，聚乙烯衬垫的内侧和外侧腔室的表面接触力百分比逐渐趋于相同。当内翻角度在 0°至 3°之间时，随着 PTS 的增加，聚乙烯衬垫的内侧腔室的最大应力平稳上升。当内翻角度在 4°至 9°之间时，随着 PTS 的增加，聚乙烯衬垫的最大应力先上升后下降，在 PTS 5°处形成一个低谷，然后再次上升。与 PTS 相比，内翻角度对聚乙烯衬垫的最大应力有较大影响（<0.001）。
当内翻角度在 0°至 3°之间时，建议选择 PTS 0°，这将使 TKA 中聚乙烯衬垫的应力分布更加均衡。
