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Updated: Jun 15, 2026
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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Initial stability of type-2 tibial defect treatments
B Frehill1, A Crocombe, S Cirovic
1Department of Mechanical, Medical, and Aerospace Engineering, University of Surrey, Guildford, UK. b.frehill@surrey.ac.uk
Summary
Metal block augments reduce stress in total knee replacement, especially for smaller defects. Avoiding stem extensions with metal blocks is recommended for better implant survival and stability.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Finite Element Analysis
Background:
- Proximal tibial defects impact total knee replacement (TKR) survival.
- Understanding stress distribution is crucial for selecting optimal TKR augmentation strategies.
Purpose of the Study:
- To analyze stresses from different augmentations for type-2 proximal tibial defects.
- To evaluate the influence of stem extensions on augment stability and stress profiles.
Main Methods:
- Finite element analysis of metal wedges, metal blocks, cement wedges, and cement blocks.
- Simulation of 15-degree and 30-degree defect angles with and without stem extensions.
- Investigation of equivalent stresses in adjacent bone regions and shear stresses at the bone-cement interface.
Main Results:
- Metal block augments exhibited the lowest equivalent stresses for both defect angles.
- Cement wedge augments resulted in the highest equivalent and shear stresses.
- Stem extensions altered stress distribution and generally increased shear stress in cement, except for metal blocks.
Conclusions:
- Metal block augments are recommended for small-defect (15-degree) TKR procedures.
- Using metal blocks without stem extensions may enhance stability and reduce stress concentration.
- Careful consideration of augment type and stem extension use is vital for TKR success.
