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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2019

01-04-2019 | Knee

Tibiofemoral conformity variation offers changed kinematics and wear performance of customized posterior-stabilized total knee arthroplasty

Authors: Yong-Gon Koh, Juhyun Son, Oh-Ryong Kwon, Sae Kwang Kwon, Kyoung-Tak Kang

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2019

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Abstract

Purpose

Posterior-stabilized (PS)-total knee arthroplasty (TKA) can be applied in any of several variations in terms of the tibiofemoral conformity and post-cam mechanism. However, previous studies have not evaluated the effect of the condylar surface radii (tibiofemoral conformity) on wear in a customized PS-TKA. The present study involved evaluating the wear performance with respect to three different conformities of the tibiofemoral articular surface in a customized PS-TKA by means of a computational simulation.

Methods

An adaptive computational simulation method was developed that conduct wear simulation for tibial insert to predict kinematics, weight loss due to wear, and wear contours to results. Wear predictions using computational simulation were performed for 5 million gait cycles with force-controlled inputs. Customized PS-TKA designs were developed and categorized as conventional conformity (CPS-TKA), medial pivot conformity (MPS-TKA), and anatomical conformity (APS-TKA). The post-cam design in the customized PS-TKA is identical. We compared the kinematics, contact mechanics, and wear performance.

Results

The findings revealed that APS-TKA exhibited the highest internal tibial rotation relative to other TKA designs. Additionally, the higher contact area led to there being less contact stress although it did not directly affect the wear performance. Specifically, MPS-TKA exhibited the lowest volumetric wear.

Conclusions

The results of the present study showed that tibiofemoral articular surface conformity should be considered carefully in customized PS-TKA design. Different wear performances were observed with respect to different tibiofemoral conformities. Even though APS-TKA exhibited an inferior wear performance compared to MPS-TKA, it proved to be better in terms of kinematics so its functionality may be improved through the optimization of the tibiofemoral articular surface conformity. Additionally, it should be carefully designed since any changes may affect the post-cam mechanism.
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Metadata
Title
Tibiofemoral conformity variation offers changed kinematics and wear performance of customized posterior-stabilized total knee arthroplasty
Authors
Yong-Gon Koh
Juhyun Son
Oh-Ryong Kwon
Sae Kwang Kwon
Kyoung-Tak Kang
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5045-9

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