ArticleBMC musculoskeletal disorders2019
Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty.
Article in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- The Effect of the Coronal Alignment of Extension Stem on Component Displacement and Stress During Total Knee Arthroplasty: A Finite Element Study.Orthopaedic surgery · 2026Article
- Does tibial sclerosis severity influence bone resorption risk following total knee arthroplasty? : finite element analysis considering implant design and surgical technique.Bone & joint research · 2026Article
- Does the clinical and radiologic outcomes following total knee arthroplasty using a new design cobalt-chrome tibial plate or predecessor different?Knee surgery & related research · 2024Article
- Tibial implant design in primary TKA: retrospective comparison of two designs for the occurrence of radiolucent lines and aseptic loosening.Archives of orthopaedic and trauma surgery · 2024Article
- Medial-lateral translational malalignment of the prosthesis on tibial stress distribution in total knee arthroplasty: A finite element analysis.Frontiers in bioengineering and biotechnology · 2023Article
- Sequential damage assessment of the posterolateral complex of the knee joint: a finite element study.Journal of orthopaedic surgery and research · 2022Article
- Current evidence base for kinematic alignment.Der Orthopade · 2020Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite potential for improving patient outcomes, studies using three-dimensional measurements to quantify proximal tibial sclerotic bone and its effects on prosthesis stability after total knee arthroplasty (TKA) are lacking. Therefore, this study aimed to determine: (1) the distribution range of tibial sclerotic bone in patients with severe genu varum using three-dimensional measurements, (2) the effect of the proximal tibial sclerotic bone thickness on prosthesis stability according to finite-element modelling of TKA with kinematic alignment (KA), mechanical alignment (MA), and 3° valgus alignment, and (3) the effect of short extension stem augment utilization on prosthesis stability.
methodsThe sclerotic bone in the medial tibial plateau of 116 patients with severe genu varum was measured and classified according to its position and thickness. Based on these cases, finite-element models were established to simulate 3 different tibial cut alignments with 4 different thicknesses of the sclerotic bone to measure the stress distribution of the tibia and tibial prosthesis, the relative micromotion beneath the stem, and the influence of the short extension stem on stability.
resultsThe distribution range of proximal tibial sclerotic bone was at the anteromedial tibial plateau. The models were divided into four types according to the thickness of the sclerotic bone: 15 mm, 10 mm, 5 mm, and 0 mm. The relative micromotion under maximum stress was smallest after MA with no sclerotic bone (3241 μm) and largest after KA with 15 mm sclerotic bone (4467 μm). Relative micromotion was largest with KA and smallest with MA in sclerotic models with the same thickness. Relative micromotion increased as thickness of the sclerotic bone increased with KA and MA (R = 0.937, P = 0.03 and R = 0.756, P = 0.07, respectively). Relative micromotion decreased with short extension stem augment in the KA model when there was proximal tibial sclerotic bone.
conclusionsThe influence of proximal tibial sclerotic bone on prosthesis's stability is significant, especially with KA tibial cut. Tibial component's short extension stem augment can improve stability.
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