Comparative Study on Three Different Designs of Locking Mechanisms in Total Knee Arthroplasty.

Abstract

The locking mechanism of the fixed-bearing tibial insert is a crucial factor in total knee arthroplasty. Previous studies have predominantly been retrieval-based, with no research examining the forces required for disassembly and assembly based on the design of the tibial insert's locking mechanism. This study aimed to measure the disassembly and assembly forces of three different locking mechanism designs. Group 1 featured a dovetail design, Group 2 had a peripheral rim design, and Group 3 combined a snap-fit mechanism with a dovetail design. Among the groups, Group 1 exhibited the highest disassembly force (379 ± 42 N), followed by Group 3 (342 ± 58) and then Group 2 (269 ± 18). Similarly, Group 1 also demonstrated the highest assembly force (71 ± 3); however, Group 3 showed a lower assembly force (48.7 ± 2.1) compared to Group 2 (49.7 ± 1.5). These results suggest that design modifications can produce mechanisms requiring minimal assembly force while maintaining strong resistance to disassembly. Due to its snap-pit structure, Group 3 exhibited the lowest assembly force while utilizing the dovetail mechanism to demonstrate a strong disassembly force. The rigorous analysis and robust methodology employed in this study ensure the reliability of the findings, which can serve as a reference for future research and development in this field.