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Abstract

Tibial locking mechanism design is adopted to limit the backside micromotion in fixed-bearing total knee replacement. However, the effect of the interference assembly of a tibial insert on the tibiofemoral contact mechanics was usually ignored. Finite element model of a fixed-bearing total knee replacement with full peripheral locking mechanism was established to simulate the interference assembly of the tibial insert, and the corresponding effects on the tibiofemoral contact mechanics were predicted. Due to the interference assembly of the tibial insert, a maximum Mises stress of 3.24 MPa was found for the tibial insert before loading. Furthermore, the contact stress was increased by 8.77%, and the contact area was decreased by 5.43% under peak load. The interference assembly of the tibial insert in a fixed-bearing total knee replacement changed the tibiofemoral contact mechanics. This study indicated that the level of interference fit should be cautiously designed for the tibial locking mechanism in fixed-bearing total knee replacement for balancing the articular surface wear and the backside wear of the modular tibial insert.

Keywords

Contact mechanics interference assembly finite element analysis total knee replacement tibial locking mechanism design

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References

Bhimji

Wang

Schmalzried

Tibial insert micromotion of various total knee arthroplasty devices. J Knee Surg 2010; 23: 153–162.

Engh

Lounici

Rao

, et al. In vivo deterioration of tibial baseplate locking mechanisms in contemporary modular total knee components. J Bone Joint Surg 2001; 83: 1660–1665.

Berry

Currier

Mayor

, et al. Knee wear measured in retrievals: a polished tray reduces insert wear. Clin Orthop Relat Res 2012; 470: 1860–1868.

Browne

Gall Sims

Giuseffi

, et al. All-polyethylene tibial components in modern total knee arthroplasty. J Am Acad Orthop Surg 2011; 19: 527–535.

Lapaj

Mroz

Kokoszka

, et al. Peripheral snap-fit locking mechanisms and smooth surface finish of tibial trays reduce backside wear in fixed-bearing total knee arthroplasty. Acta Orthop 2017; 88: 62–69.

Sisko

Teeter

Lanting

, et al. Current total knee designs: does baseplate roughness or locking mechanism design affect polyethylene backside wear? Clin Orthop Relat Res 2017; 475: 2970–2980.

Rao

Engh

Collier

, et al. Tibial interface wear in retrieved total knee components and correlations with modular insert motion. J Bone Joint Surg Am 2002; 84A: 1849–1855.

Jayabalan

Furman

Cottrell

, et al. Backside wear in modern total knee designs. HSS J 2007; 3: 30–34.

Galvin

Jennings

McEwen

, et al. The influence of tibial tray design on the wear of fixed-bearing total knee replacements. Proc IMechE, Part H: J Engineering in Medicine 2008; 222: 1289–1293.

10.

Muratoglu

Rubash

Bragdon

, et al. Simulated normal gait wear testing of a highly cross-linked polyethylene tibial insert. J Arthroplasty 2007; 22: 435–444.

11.

Levine

Lewicki

Currier

, et al. Contribution of micro-motion to backside wear in a fixed bearing total knee arthroplasty. J Orthop Res 2016; 34: 1933–1940.

12.

Ardestani

Moazen

Chen

, et al. A real-time topography of maximum contact pressure distribution at medial tibiofemoral knee implant during gait: application to knee rehabilitation. Neurocomputing 2015; 154: 174–188.

13.

Zhang

Chen

Wang

, et al. A patient-specific wear prediction framework for an artificial knee joint with coupled musculoskeletal multibody-dynamics and finite element analysis. Tribol Int 2017; 109: 382–389.

14.

Strickland

Dressler

Taylor

Predicting implant UHMWPE wear in-silico: a robust, adaptable computational-numerical framework for future theoretical models. Wear 2011; 274: 100–108.

15.

Gao

Zhang

Jin

Explicit finite element modeling of kinematics and contact mechanics of artificial hip and knee joints. In: Proceedings of the 14th IFToMM world congress, Taipei, Taiwan, 25–30 October 2015. DOI: 10.6567/IFToMM.14TH.WC.OS2.002.

16.

O’Brien

Luo

Brandt

JM.

In-vitro and in-silico investigations on the influence of contact pressure on cross-linked polyethylene wear in total knee replacements. Wear 2015; 332–333: 687–693.

17.

O’Brien

Luo

, et al. Prediction of backside micromotion in total knee replacements by finite element simulation. Proc IMechE, Part H: J Engineering in Medicine 2012; 226: 235–245.

18.

Godest

Beaugonin

Haug

, et al. Simulation of a knee joint replacement during a gait cycle using explicit finite element analysis. J Biomech 2002; 35: 267–275.

19.

Abdelgaied

Liu

Brockett

, et al. Computational wear prediction of artificial knee joints based on a new wear law and formulation. J Biomech 2011; 44: 1108–1116.

20.

Willing

Kim

IY.

A holistic numerical model to predict strain hardening and damage of UHMWPE under multiple total knee replacement kinematics and experimental validation. J Biomech 2009; 42: 2520–2527.

21.

ISO 14243-3:2014. Implants for surgery—wear of total knee-joint prostheses—part 3: loading and displacement parameters for wear-testing machines with displacement control and corresponding environmental conditions for test.

22.

Abdelgaied

Fisher

Jennings

LM.

A comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements. J Mech Behav Biomed Mater 2018; 78: 282–291.

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Effects of interference assembly of a tibial insert on the tibiofemoral contact mechanics in total knee replacement

Abstract

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References

Supplementary Material