슬관절 전치환술에서 후방 안정 임플란트의 오정렬이 경골 기둥에 미치는 영향
Influence of Malalignment on Tibial Post in Total Knee Replacement Using Posterior Stabilized Implant
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Recently, it has been reported that the posterior stabilized implant, which is clinically used for the total knee replacement (TKR), may have failure risk such as wear or fracture by the contact pressure and stress on the tibial post. The purpose of this study is to investigate the influence of the malalignment of the posterior stabilized implant on the tibial post by estimating the distributions of contact pressure and von-Mises stress on a tibial post and to analyze the failure risk of the tibial post. Finite element models of a knee joint and an implant were developed from 1mm slices of CT images and 3D CAD software, respectively. The contact pressure and the von-Mises stress applying on the implant were analyzed by the finite element analysis in the neutral alignment as well as the 8 malalignment cases (3 and 5 degrees of valgus and varus angulations, and 2 and 4 degrees of anterior and posterior tilts). Loading condition at the 40% of one whole gait cycle such as 2000N of compressive load, 25N of anterior-posterior load, and 6.5Nm of torque was applied to the TKR models. Both the maximum contact pressure and the maximum von-Mises stress were concentrated on the anterior-medial region of the tibial post regardless of the malalignment, and their magnitudes increased as the degree of the malalignment increased. From present result, it is shown that the malalignment of the implant can influence on the failure risk of the tibial post.
참고문헌 (22)
- H.D. Clarke, "Polyethylene post failure in posterior stabilized total knee arthroplasty", 19, pp.652~657 (2004)
- S. Matsuda, "Change in knee alignment after total knee arthroplasty", 14, pp.566~570 (1999)
- J. Halloran P, "Explicit finite element modeling of total knee replacement mechanics", 38, pp.323~331 (2005)
- Y.S. Chiu, "Fracture of the polyethylene tibial post in a NexGen posteriorstabilized knee prosthesis", 19, pp.1045~1049 (2004)
- G.H. van Lenthe, "Stress shielding after total knee replacement may cause bone resorption in the distal femur", 79-b, pp.117~122 (1997)
- J.J. Liau, "The effect of malalignment on stresses in polyethylene component of total knee prostheses - a finite element analysis", 17, pp.140~146 (2002)
- A. Perillo-Marcone, "“The importance of tibial alignment - finite element analysis of tibial malalignment", 15, pp.1020~1027 (2000)
- S.K.T. Puloski, "Tibial post wear in posterior stabilized total knee arthroplasty an unrecognized source of polyethylene debris", 83-a, pp.390~397 (2001)
- T. Villa, "Contact stresses and fatigue life in a knee prosthesis comparison between in vitro measurements computational simulations", 37, pp.45~53 (2004)
- M.J.K. Bankes, "The effect of component malalignment on the clinical and radiological outcome of the Kinemax total knee replacement", 10, pp.55~60 (2003)
- F.W. Werner, "The effect of valgus", varus alignment on load distribution in total knee replacements, 2005., pp.38, 349~355
- J.J. Callaghan, "Tibial post impingement in posterior-stabilized total knee arthroplasty", 404, pp.83~88 (2002)
- R.C. Wasielewski, "Tibial insert undersurface as a contributing source of polyethylene wear debris", 345, pp.53~59 (1997)
- W. Mesfar, "Biomechanics of the knee joint in flexion under various quadriceps forces", pp.424~434 (2005)
- E. Pena, "A threedimensional finite element analysis of the combined behavior of ligaments and menisci in the healthy human knee joint", 39, pp.1686~1701 (2006)
- P. Mestha, "Fracture of the polyethylene tibial post in posterior stabilized", 15, pp.814~815 (2000)
- C.H. Huang, "Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty - a case report", 14, pp.375~379 (1999)
- D.L. Bartel, "Stresses in polyethylene components of contemporary total knee replacements", 317, pp.76~82 (1995)
- C.H. Huang, "Influence of post-cam design on stresses on posterior-stabilized tibial posts", 450, pp.150~156 (2006)
- G. Li, "A validated three- dimensional computational model of a human knee joint", 121, pp.657~662 (1999)
- C.S. Heim, "“Tibial plateau surface stress in TKA"
- W.L. Sauer, "Fatigue performance of ultra-high-molecular-weight polyethylene: effect of gamma radiation sterilization", 17, pp.1929~1935 (1996)