The Biomechanical Effect of Stem Design and Methods of Fixation in Revision Total Knee Arthroplasty

Oh Soo Kwon; Dae Kyung Bae; Yoon Hyuk Kim

doi:10.4055/jkoa.2007.42.2.196

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Kwon, Bae, and Kim: The Biomechanical Effect of Stem Design and Methods of Fixation in Revision Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(2): 196-203.

Published online: 30 April 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.2.196

The Biomechanical Effect of Stem Design and Methods of Fixation in Revision Total Knee Arthroplasty

Oh Soo Kwon, M.D., Dae Kyung Bae, M.D.^*, Yoon Hyuk Kim, Ph.D.^†

Department of Orthopaedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijongbu, Korea.

^*Department of Orthopaedic Surgery, College of Medicine, Seoul, Korea.

^†School of Advanced Technology, Kyung Hee University, Yongin, Korea.

Address reprint requests to Oh Soo Kwon, M.D. Department of Orthopaedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, 65-1, Geumo-dong, Uijeongbu 480-130, Korea. Tel: +82.31-820-3878, Fax: +82.31-847-3671, oskn@catholic.ac.kr

Abstract

Purpose

This study examined the effect of the stem design and method of fixation on biomechanical features around a stem tip in revision total knee arthroplasty using finite analysis.

Materials and Methods

A 3D Finite element model was reconstructed for a CT scan of the normal tibia from a 26 year old male and the CAD model of total knee arthroplasty revision was developed. The design change in the stem such as the length, diameter, slot, press fit and coefficient of friction was performed. The contact pressure, von-Meises stress around the stem and the micromotion were evaluated.

Results

A longer length and larger diameter press fit stem significantly increased the contact pressure and stress at the end of stem. The distal slot reduces the contact pressure and stress at the end of stem. Less displacement between the tibial component and bone was noted in the increased coefficient of friction.

Conclusion

A stem with shorter length sufficient to engage proximal diaphysis, a closer diameter of the proximal canal and a minimal press fit can be used to reduce the contact pressure and stress if the patient's surgical anatomy such as bone loss and quality is tolerable in revision total knee arthroplasty.

Keywords: Revision total knee arthroplasty, Stem tip, Biomechanics

Figures and Tables

Fig. 1

Contact pressure and von Meises stress according to the changes in the length of the stem.

Fig. 2

Contact pressure and von Meises stress according to the changes in the diameter of the stem.

Fig. 3

Contact pressure and von Meises stress according to the press fit.

Fig. 4

Contact pressure and von Meises stress according to the presence of slot.

Fig. 5

Displacement between the tray and tibia according to the changes in the coefficient of friction.

Fig. 6

Displacement between the stem and tibia according to the changes in the coefficient of friction.

Table 1

Parameters of the Biomechanical Experiment

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