Figgie H E, Davy D T, Heiple K G, Hart R T
Clin Orthop Relat Res. 1984 Mar(183):288-97.
The load-bearing capability of the tibial component of total knee prostheses is affected by the coverage of the osteotomized tibial surface by the tibial component. An anthropometric study of the proximal tibia indicated that standard total condylar tibial knee components may significantly underutilize the available weight-bearing tibial surface. The unloaded area values ranged from 6% to 43% in males and from 1% to 25% in females. An experimental study of the load-bearing capability of both standard tibial components and tibial components custom-fitted to conform to the periphery of the upper tibial surface was performed. Improvement in single load to failure with the conforming prosthesis averaged 29% in females with stemless prosthesis, 21% in females with stemmed prostheses, 41% in males with stemless prostheses, and 89% in males with stemmed prostheses. Post-test examination of the failed tibiae with conforming implants indicated failure by major fragmenting of the proximal tibia rather than cancellous bone crushing, suggesting that the maximal load-bearing ability of the upper tibial surface was more nearly being achieved. The results demonstrate the benefit to be gained by fully utilizing the available tibial surface for load transmission across the joint and suggest that use of custom-fitted tibial components has considerable merit.
全膝关节假体胫骨部件的承重能力受胫骨部件对截骨后胫骨表面的覆盖情况影响。一项对胫骨近端的人体测量学研究表明，标准的全髁型胫骨膝关节部件可能会显著未充分利用可用的负重胫骨表面。男性的非负重面积值在6%至43%之间，女性在1%至25%之间。对标准胫骨部件和根据胫骨上表面周边定制的胫骨部件的承重能力进行了一项实验研究。对于顺应性假体，女性无柄假体单次破坏载荷平均提高29%，女性有柄假体提高21%，男性无柄假体提高41%，男性有柄假体提高89%。对植入顺应性假体后失败的胫骨进行的测试后检查表明，近端胫骨主要是因骨折而非松质骨挤压而失败，这表明胫骨上表面的最大承重能力更接近得到实现。结果证明了充分利用可用胫骨表面进行关节间载荷传递所带来的益处，并表明使用定制的胫骨部件有相当大的优点。
