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Damage in total knee replacements from mechanical overload.

William F Zimmerman1, Mark A Miller1, Richard J Cleary2

  • 1Department of Orthopedic Surgery, State University of New York, Upstate Medical University, 3216 IHP, 750 East Adams Street, Syracuse, NY 13210, USA.

Journal of Biomechanics
|May 31, 2016
PubMed
Summary
This summary is machine-generated.

Mechanical loads from daily activities can stress total knee replacements (TKR). Some TKRs may fail under high impact, risking aseptic loosening and implant failure.

Keywords:
Aseptic looseningBone damageMicromotionPostmortem retrievalsTotal knee replacement

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Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Materials Science

Background:

  • Recent studies measured mechanical loads on knee joints after total knee replacement (TKR) using instrumented TKRs.
  • Investigating implant-bone interface integrity under physiological loads is crucial for TKR longevity.

Purpose of the Study:

  • To assess if mechanical loads from daily activities can damage the implant-bone interface or tibial bone in retrieved TKR constructs.
  • To determine the risk of failure under varying physiological loads and identify factors influencing bone strain and micromotion.

Main Methods:

  • Examined 18 cemented tibial components (0-22 years in service) under axial compression (1-10x body weight).
  • Utilized digital image correlation to measure bone strain and interface micromotion.
  • Defined failure as micromotion >150µm or bone strain >7300µε.

Main Results:

  • All specimens showed sufficient bone strength for most daily activities.
  • ~40% of TKRs were at risk under higher impact loads (e.g., jogging, stumbling).
  • Increased tray-bone micromotion correlated with younger donor age at implantation; increased bone strain correlated with longer service time and lower bone mineral density.

Conclusions:

  • High mechanical overload, whether single or repetitive, may initiate aseptic loosening in total joint arthroplasties.
  • Avoiding high mechanical loads is essential to prolong the lifespan of TKR implants.
  • Factors like patient age, implant duration, and bone quality influence TKR mechanical response.