ArticleBioengineering (Basel, Switzerland)2022
Biomechanical Analysis of the Use of Stems in Revision Total Knee Arthroplasty.
Article in Bioengineering (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Tibial stem extension versus standard configuration in primary cemented total knee arthroplasty: systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Uncemented slotted stem versus short stem for distal femoral endoprosthetic reconstruction in pediatric bone tumor patients: a retrospective analysis of prosthetic performance and functional outcomes.Journal of orthopaedic surgery and research · 2026Article
- Biomechanical analysis of surgical alignment and design in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Effect of design and surgical parameters variations in mobile-bearing versus fixed-bearing unicompartmental knee arthroplasty: A finite element analysis.Journal of experimental orthopaedics · 2024Article
- Biomechanical analysis of patient specific cone vs conventional stem in revision total knee arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Clinical outcome and survival rate of condylar constrained knee prosthesis in revision total knee arthroplasty: an average nine point six year follow-up.International orthopaedics · 2024Article
- Aseptic midterm survival rates between different cemented tibial stem designs in hinged total knee arthroplasty: a 6-year evaluation from the German Arthroplasty Registry.Archives of orthopaedic and trauma surgery · 2024Article
- Is the Citak classification of distal femur morphology age and gender dependent?Archives of orthopaedic and trauma surgery · 2023Article
- Application strategy of finite element analysis in artificial knee arthroplasty.Frontiers in bioengineering and biotechnology · 2023Review
- Total Knee Arthroplasty with Non-Stemmed Tibial Components among Obese Patients: Clinical and Radiologic Evaluation and Review of Literature.Bulletin of emergency and trauma · 2023Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Adequate fixation is fundamental in revision total knee arthroplasty; consequently, surgeons must determine the correct set-up for each patient, choosing from numerous stem solutions. Several designs are currently available on the market, but there are no evidence-based quantitative biomechanical guideline yet. Therefore, several stems were designed and analyzed using a previously-validated finite-element model. The following parameters were studied: stem design characteristics (length and shape), added features (straight/bowed stem), fixation technique, and effect of slots/flutes. Bone stress and Risk of Fracture (RF) were analyzed in different regions of interest during a squat (up to 120°). For the femoral stem, the results indicated that all parameters influenced the bone stress distribution. The maximum von Mises stress and RF were always located near the tip of the stem. The long stems generated stress-shielding in the distal bone. Regarding the tibial stem, cemented stems showed lower micromotions at the bone-tibial tray interface and at the stem tip compared to press-fit stems, reducing the risk of implant loosening. The results demonstrated that anatomical shapes and slots reduce bone stress and risk of fracture, whereas flutes have the opposite effect; no relevant differences were found in this regard when alternating cemented and press-fit stem configurations. Cemented tibial stems reduce antero-posterior micromotions, preventing implant loosening.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.