A circumferentially flanged tibial tray minimizes bone-tray shear micromotion

Aseptic loosening of the tibial component is the major complication of total knee arthroplasty. There is an association between early excessive shear micromotion between the bone and the tray of the tibial component and late aseptic loosening. Using non-linear finite element analysis, whether a tibial tray with a circumferentially flanged rim and a mating cut in the proximal tibia could minimize bone-tray shear micromotion was considered. Fifteen competing tray designs with various degrees of flange curvature were assessed with the aim of minimizing bone-tray shear micromotion. A trade-off was found between reducing micromotion and increasing peripheral cancellous bone stresses. It was found that, within the limitations of the study, there was a theoretical design that could virtually eliminate micromotion due to axial loads, with minimal bone removal and without the use of screws or pegs.