Micromotion and Migration of Cementless Tibial Trays Under Functional Loading Conditions
| Autor: | Rikin Patel, Hugh L. Jones, Jonathan Gold, Shuyang Han, Sabir K. Ismaily, Philip C. Noble |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
Digital image correlation Total knee arthroplasty Walking Prosthesis Design Rotation 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Range of Motion Articular Arthroplasty Replacement Knee Orthodontics 030222 orthopedics Tibia business.industry musculoskeletal system Sagittal plane Transverse plane medicine.anatomical_structure Tray Implant Knee Prosthesis business Cadaveric spasm human activities |
| Zdroj: | The Journal of Arthroplasty. 36:349-355 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2020.07.017 |
| Popis: | The outcome of cementless total knee arthroplasty (TKA) relies on successful bony ingrowth into the implant surfaces. Failures due to aseptic loosening are still reported, especially in younger and more active patients. The objective of this study is to quantify the micromotion of a commercially available design of cementless tibial tray under loading conditions simulating walking and stair descent.A commercially available design of cementless total knee arthroplasty was implanted in 7 cadaveric knees which were preconditioned with 500 cycles of 0°-100° flexion under a vertical load of 1050 N in a custom-built, multiaxial functional activity simulator. This was followed by application of the peak forces and moments occurring during walking and stair descent. During each loading procedure, 3-dimensional motion at the bone-prosthesis interface was measured using digital image correlation.The tray migrated 101 ± 25 μm on average during preconditioning, which was dominated by rotation in the sagittal plane (92% of total migration), combined with posterior translation (28%) and minimal rotation in the transverse plane (14%). The migration varied 2.7-fold (61-167 μm) between the 6 measurement zones. Stair descent produced significantly higher total micromotion than walking in zone #5 (62 ± 9 vs 51 ± 10 μm, P.05) and zone #6 (68 ± 17 vs 37 ± 10 μm, P.05). In addition, during stair descent, the tray exhibited significantly more tilting (anterior zones: 31 ± 17 vs -16 ± 20 μm, P.05; posterior zones: -60 ± 8 vs -40 ± 7 μm, P.05) and more anteroposterior displacement in the anterior zones (-25 ± 3 vs -13 ± 2 μm, P.05) when compared to walking.The relative motion at the bone-prosthesis interface varied substantially around the periphery of the cementless tray. Under the loading conditions evaluated, the tray primarily underwent a rocking motion in the sagittal plane. Compared with walking, stair descent produced significantly more micromotion, especially in the posterior zones. |
| Databáze: | OpenAIRE |
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