Analysis of different bicruciate-retaining tibial prosthesis design using a three dimension finite element model

The recent interest in bicruciate-retaining prostheses has aimed to address the need for an implant that can mimic a natural knee. Arguments have always existed about survivorship, including loosening and subsidence, as well as tibial preparation in bicruciate-retaining tibial prostheses. The aim of this study was to investigate the biomechanics of a new modular design and other bicruciate-retaining designs using a three-dimensional finite element model under different load conditions to discover which prosthesis was more suitable. We also evaluated related parameters (the third principal stress, shear stress, micromotion, and von Mises stresses) to compare the characteristics of different bicruciate-retaining designs. The biomechanics of the bicruciate-retaining tibial prosthesis can be influenced by the style of the designed prosthesis and gait loading. The new modular design showed stability and moderated the third principal stress, leading to less shear stress and stress shield, suggesting that this type of design can avoid knee prosthesis loosening and subsidence. Therefore, the new design may be used as a more suitable prosthesis for future bicruciate-retaining implant application.