論文

査読有り
2018年3月1日

Medial tilting of the joint line in posterior stabilized total knee arthroplasty increases contact force and stress

Clinical Biomechanics
  • Yoshihisa Tanaka
  • ,
  • Shinichiro Nakamura
  • ,
  • Shinichi Kuriyama
  • ,
  • Kohei Nishitani
  • ,
  • Hiromu Ito
  • ,
  • Moritoshi Furu
  • ,
  • Mutsumi Watanabe
  • ,
  • Shuichi Matsuda

53
開始ページ
54
終了ページ
59
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.clinbiomech.2018.02.008
出版者・発行元
Elsevier Ltd

Background: Kinematically aligned total knee arthroplasty is based on the concept to represent the premorbid joint alignment with cruciate-retaining implants, characterized by medial tilt and internal rotation. However, kinematic and kinetic effects of kinematically aligned total knee arthroplasty with posterior-stabilized implants is unknown. The purpose of this study was to examine the effect of medial tilting of the joint line with posterior-stabilized implants. Methods: A mechanical alignment model, and medial tilt 3° and 5° models were constructed. Knee kinematics and contact forces were simulated using a musculoskeletal computer simulation model. Contact stresses on the tibiofemoral joint and the post area were then calculated using finite element analysis. Findings: From 0° to 120° of knee flexion, greater external rotation of the femoral component was observed in medial tilt models (−0.6°, 1.8° and 4.2° in mechanical alignment, medial tilt 3° and medial tilt 5° models, respectively). The peak contact stresses on the tibiofemoral joint and the post area at 120° of knee flexion were higher in medial tilt models. The peak contact stresses on the post area in medial tilt 3° and 5° models were 2.2 and 3.8 times greater than that in mechanical alignment model, respectively. Interpretation: Medial tilting of the joint line causes greater axial rotation even with posterior-stabilized implants, which can represent near-normal kinematics. However, medial tilting of the joint line in total knee arthroplasty with posterior-stabilized implants may have a higher risk for polyethylene wear at the tibiofemoral joint and post area, leading to subsequent component loosening.

リンク情報
DOI
https://doi.org/10.1016/j.clinbiomech.2018.02.008
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29448081
ID情報
  • DOI : 10.1016/j.clinbiomech.2018.02.008
  • ISSN : 1879-1271
  • ISSN : 0268-0033
  • PubMed ID : 29448081
  • SCOPUS ID : 85041809566

エクスポート
BibTeX RIS