Contact stress analysis of the anterior tibial post in bi-cruciate stabilized and mobile-bearing posterior stabilized total knee arthroplasty designs. (July 2016)

• Record Type: Journal Article
• Authors: Kuwashima, Umito; Hamai, Satoshi; Okazaki, Ken; Ikebe, Satoru; Higaki, Hidehiko; Mizu-uchi, Hideki; Akasaki, Yukio; Murakami, Koji; Iwamoto, Yukihide
• Is Part Of: Journal of the mechanical behavior of biomedical materials. Volume 60(2016)
• Page Start: 460
• Page End: 467
• Publication Date: 2016-07
• Subjects: AP anteroposterior -- BCS bi-cruciate stabilized -- PS posterior-stabilized -- TKA total knee arthroplasty; Biomedical materials -- Periodicals; Biomedical materials -- Mechanical properties -- Periodicals; Biomedical materials; Biomedical materials -- Mechanical properties; Periodicals; Electronic journals; 610.28
• DOI: 10.1016/j.jmbbm.2016.03.003
• Languages: English
• ISSNs: 1751-6161

Abstract

Abstract: In posterior-stabilized (PS) total knee arthroplasty (TKA), unexpected wear and fracture of the tibial post due to anterior post impingement have been reported. The purpose of this study was to determine the contact stress on the anterior aspect of the tibial post in four contemporary TKA designs. We evaluated one bi-cruciate stabilized design (Journey II) and three mobile-bearing PS designs (Vanguard RP, PFC Sigma RP, and NexGen LPS Mobile). The contact conditions at the anterior aspect of the tibial post were determined upon application of a posterior force of 100 N to individual implants. Each measurement was sequentially performed five times, and the data were compared within and across designs using analysis of variance and a post-hoc test. The contact stress of the Journey II and Vanguard RP was less than the compressive yield stress for polyethylene (10 MPa) at all tested flexion angles and degrees of rotation. The PFC Sigma RP did not show anterior tibial post impingement under any experimental conditions. The NexGen LPS Mobile demonstrated bilateral edge loading at the anterior tibial post and exceeded 10 MPa of contact stress in some test conditions. Thus, the differences among implants in terms of the dimensions of the femoral anterior cam or intercondylar notch and the anterior aspect of the tibial post in the axial and sagittal planes led to significant differences in contact conditions. The present study helps the surgeon to be more aware that various contact conditions of the anterior aspect of the tibial post can occur in individual TKA designs. Graphical abstract: Highlights: We determined contact stress of anterior tibial post in total knee arthroplasties. We evaluated one bi-cruciate stabilized design and three mobile-bearing designs. A bi-cruciate stabilized design had stable contact under all test conditions. Mobile-bearing designs showed various impingement patterns, including no contact. Differences across the designs led to significant differences in contact conditions.