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, 7 (1), 20-27

Patient-specific Medial Unicompartmental Knee Arthroplasty Has a Greater Protective Effect on Articular Cartilage in the Lateral Compartment: A Finite Element Analysis

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Patient-specific Medial Unicompartmental Knee Arthroplasty Has a Greater Protective Effect on Articular Cartilage in the Lateral Compartment: A Finite Element Analysis

K-T Kang et al. Bone Joint Res.

Abstract

Objectives: Patient-specific (PS) implantation surgical technology has been introduced in recent years and a gradual increase in the associated number of surgical cases has been observed. PS technology uses a patient's own geometry in designing a medical device to provide minimal bone resection with improvement in the prosthetic bone coverage. However, whether PS unicompartmental knee arthroplasty (UKA) provides a better biomechanical effect than standard off-the-shelf prostheses for UKA has not yet been determined, and still remains controversial in both biomechanical and clinical fields. Therefore, the aim of this study was to compare the biomechanical effect between PS and standard off-the-shelf prostheses for UKA.

Methods: The contact stresses on the polyethylene (PE) insert, articular cartilage and lateral meniscus were evaluated in PS and standard off-the-shelf prostheses for UKA using a validated finite element model. Gait cycle loading was applied to evaluate the biomechanical effect in the PS and standard UKAs.

Results: The contact stresses on the PE insert were similar for both the PS and standard UKAs. Compared with the standard UKA, the PS UKA did not show any biomechanical effect on the medial PE insert. However, the contact stresses on the articular cartilage and the meniscus in the lateral compartment following the PS UKA exhibited closer values to the healthy knee joint compared with the standard UKA.

Conclusion: The PS UKA provided mechanics closer to those of the normal knee joint. The decreased contact stress on the opposite compartment may reduce the overall risk of progressive osteoarthritis.Cite this article: K-T. Kang, J. Son, D-S. Suh, S. K. Kwon, O-R. Kwon, Y-G. Koh. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: A Finite Element Analysis. Bone Joint Res 2018;7:20-27. DOI: 10.1302/2046-3758.71.BJR-2017-0115.R2.

Keywords: Finite element analysis; Patient-specific implant; Unicompartmental knee arthroplasty.

Figures

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Design process of patient-specific unicompartmental knee arthroplasty for the a) subject's anatomic ‘J’ curve; b) spline curves used to model the femoral component; c) femoral component; and d) polyethylene insert that provides an anatomical fit and a perfect coverage.
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Finite element models used in the analysis: (a) normal knee; (b) patient-specific unicompartmental knee arthroplasty (UKA); and (c) standard UKA.
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Tibial translations in the anterior (a) and posterior (b) drawer tests under 130 N. The error bars indicate 1 standard error.
Fig. 4
Fig. 4
Maximum contact stress on the polyethelene (PE) insert in patient-specific (PS) unicompartmental knee arthroplasty (UKA) and standard UKA.
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Maximum contact stress on a) articular cartilage (of the lateral compartment only) and; b) lateral meniscus in the normal knee, patient-specific (PS) unicompartmental knee arthroplasty (UKA), and standard UKA.

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