Prediction of wear performance in femoral and tibial conformity in patient-specific cruciate-retaining total knee arthro
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(2020) 15:24
RESEARCH ARTICLE
Open Access
Prediction of wear performance in femoral and tibial conformity in patient-specific cruciate-retaining total knee arthroplasty Yong-Gon Koh1†, Kyoung-Mi Park2†, Hwa-Yong Lee2, Joon-Hee Park3*† and Kyoung-Tak Kang2*†
Abstract Background: Articular surface curvature design is important in tibiofemoral kinematics and the contact mechanics of total knee arthroplasty (TKA). Thus far, the effects of articular surface curvature have not been adequately discussed with respect to conforming, nonconforming, and medial pivot designs in patient-specific TKA. Therefore, this study evaluates the underlying relationship between the articular surface curvature geometry and the wear performance in patient-specific TKA. Methods: We compare the wear performances between conventional and patient-specific TKA under gait loading conditions using a computational simulation. Patient-specific TKAs investigated in the study are categorized into patientspecific TKA with conforming articular surfaces, medial pivot patient-specific TKA, and bio-mimetic patient-specific TKA with a patient’s own tibial and femoral anatomy. The geometries of the femoral components in patient-specific TKAs are identical. Results: The anterior-posterior and internal-external kinematics change with respect to different TKA designs. Moreover, the contact pressure and area did not directly affect the wear performance. In particular, conforming patient-specific TKAs exhibit the highest volumetric wear and wear rate. The volumetric wear in a conforming patient-specific TKA is 29% greater than that in a medial pivot patient-specific TKA. Conclusion: The findings in this study highlight that conformity changes in the femoral and tibial inserts influence the wear performance in patient-specific TKA. Kinematics and contact parameters should be considered to improve wear performance in patient-specific TKA. The conformity modification in the tibiofemoral joint changes the kinematics and contact parameters, and this affects wear performance. Keywords: Total knee arthroplasty, Patient-specific implant, Conformity, Wear, Finite element analysis
Introduction Total knee arthroplasty (TKA) is considered an extremely effective treatment procedure for knee pain associated with degenerative joint disease [1–3]. Several technologies were recently developed to provide better functional outcomes in TKA. Primary TKA is widely * Correspondence: [email protected]; [email protected] † Yong-Gon Koh and Kyoung-Mi Park contributed equally to this work and should be considered co-first authors. † Joon-Hee Park and Kyoung-Tak Kang contributed equally to this work and should be considered co-corresponding authors. 3 Department of Anesthesiology & Pain Medicine, Hallym University College of Medicine and Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea 2 Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea Full list of author information is avail
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