Appropriate sagittal positioning of femoral components in total knee arthroplasty to prevent fracture and loosening.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2024-10-24 DOI:10.1302/2046-3758.1310.BJR-2023-0362.R2
Qian Wan, Qing Han, Yang Liu, Hao Chen, Aobo Zhang, Xue Zhao, Jincheng Wang
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Abstract

Aims: This study aimed to investigate the optimal sagittal positioning of the uncemented femoral component in total knee arthroplasty to minimize the risk of aseptic loosening and periprosthetic fracture.

Methods: Ten different sagittal placements of the femoral component, ranging from -5 mm (causing anterior notch) to +4 mm (causing anterior gap), were analyzed using finite element analysis. Both gait and squat loading conditions were simulated, and Von Mises stress and interface micromotion were evaluated to assess fracture and loosening risk.

Results: During gait, varied sagittal positioning did not lead to excessive Von Mises stress or micromotion. However, under squat conditions, posterior positioning (-4 and -5 mm) resulted in stress exceeding 150 MPa at the femoral notch, indicating potential fracture risk. Conversely, +1 mm and 0 mm sagittal positions demonstrated minimal interface micromotion.

Conclusion: Slightly anterior sagittal positioning (+1 mm) or neutral positioning (0 mm) effectively reduced stress concentration at the femoral notch and minimized interface micromotion. Thus, these positions are deemed suitable to decrease the risk of aseptic loosening and periprosthetic femoral fracture.

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在全膝关节置换术中对股骨组件进行适当的矢状定位,以防止骨折和松动。
目的:本研究旨在探讨全膝关节置换术中非骨水泥股骨组件的最佳矢状定位,以最大限度地降低无菌性松动和假体周围骨折的风险:采用有限元分析方法分析了股骨组件的十种不同矢状位置,从-5毫米(造成前方凹槽)到+4毫米(造成前方间隙)不等。模拟了步态和下蹲加载条件,并评估了冯米塞斯应力和界面微动,以评估骨折和松动风险:结果:在步态过程中,不同的矢状定位不会导致过大的 Von Mises 应力或微动。然而,在下蹲条件下,后方定位(-4 和-5 毫米)导致股骨缺口处的应力超过 150 兆帕,表明存在潜在的骨折风险。相反,+1 毫米和 0 毫米的矢状定位显示出最小的界面微动:结论:矢状位稍前(+1 毫米)或中立位(0 毫米)可有效减少股骨切迹处的应力集中,并将界面微动降至最低。因此,这些位置被认为适合用于降低无菌性松动和股骨假体周围骨折的风险。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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