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Published on: November 23, 2019
Coronal malposition effects in total knee arthroplasty: a finite element analysis.
Gabriel Stan1, Horia Orban, Lucian Gruionu
1Department of Orthopaedics and Traumatology, Elias Universitary Hospital, 17 Marasti Boulevard, 011461 Bucharest, Romania.
Summary
Balancing prosthetic knee components in the coronal plane, even with slight malalignment, improves load distribution and reduces bone stress. This is crucial for prosthetic survival when perfect alignment isn't achievable.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Medical device design
Background:
- Prosthetic component malposition is a common issue in knee replacements, often due to technical challenges without navigation.
- Varus malalignment can negatively impact load distribution and implant longevity.
Purpose of the Study:
- To investigate the biomechanical effects of prosthetic component alignment in the coronal plane.
- To evaluate load distribution and contact pressure in different malalignment scenarios of prosthetic knees.
Main Methods:
- Finite element analysis was used to simulate load intensity and distribution.
- Three scenarios were studied: ideal alignment, unbalanced varus malposition, and balanced varus malposition with parallel components.
Main Results:
- A balanced knee with an inclined interline showed higher contact pressure than ideal alignment but lower than an unbalanced knee.
- Tibial varus malpositions of 3° and 8° were simulated.
- Additional medial plateau resection (2-4mm) in a balanced knee did not significantly alter load distribution.
Conclusions:
- Component balancing is critical for prosthetic survival when coronal malposition is unavoidable.
- Achieving balance, even with some malalignment, can mitigate negative biomechanical consequences.
