Test Method for Evaluating Motion between the Polymeric Articulating Surface and the Tibial Tray of Modular Total Knee Systems

2009 ◽  
pp. 94-94-10
Author(s):  
LA Kirkpatrick
Keyword(s):  
Test Method ◽  
Tibial Tray ◽  
Total Knee ◽  
Articulating Surface

Joint gap measurement in total knee arthroplasty using a tensor device with the same articulating surface as the prosthesis

2014 ◽  
Vol 134 (5) ◽  
pp. 699-705 ◽  
Author(s):  
Yoshio Matsui ◽  
Shigeru Nakagawa ◽  
Yukihide Minoda ◽  
Shigekazu Mizokawa ◽  
Yoshio Tokuhara ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Gap Measurement ◽  
Joint Gap ◽  
Total Knee ◽  
Articulating Surface

The Posterolateral Corner-Locked Technique Is Applicable in a Chinese Population Regarding the Tibial Component Rotation Alignment in Total Knee Arthroplasty

2019 ◽  
Vol 33 (05) ◽  
pp. 466-473
Author(s):  
Chao-Hua Fang ◽  
Cheng-Kung Cheng ◽  
Tie-Bing Qu ◽  
Jun-Hui Zhang ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Chinese Population ◽  
Posterolateral Corner ◽  
Tibial Tubercle ◽  
Tibial Osteotomy ◽  
Tibial Tray ◽  
Total Knee ◽  
Asymmetrical Design

AbstractRotational malalignment between the femoral and tibial components in total knee arthroplasty (TKA) can affect clinical outcomes, but there is no consensus on how to best determine tibia tray orientation. The posterolateral corner-locked (PLCL) technique may be a new method. This study aims to assess the applicability of this technique in a Chinese population. Forty normal Chinese volunteers were recruited and underwent computed tomography (CT) of the lower limbs. Knee model reconstructions and simulated standard tibial osteotomy were conducted digitally. The transepicondylar axis (TEA), the Akagi line, and the line connecting the medial third of the tibial tubercle with the midpoint of the posterior cruciate ligament (PCL) were projected to the tibial cross-section and marked. The PLCL technique was applied using either symmetrical or asymmetrical tibial tray templates, and the anteroposterior (AP) axis of the tibial tray was marked. The angles between the TEA and these lines were calculated, and the statistical differences were analyzed. The angle between the TEA and the Akagi line and between the TEA and the line connecting the medial third of the tibial tubercle with the midpoint of the PCL were 96.90 ± 5.57 and 107.31 ± 5.95 degrees, respectively. The angles between the TEA and the AP axis of the symmetrical and the asymmetrical design tibial trays were 94.01 ± 4.21 and 96.65 ± 4.70 degrees, respectively. Except for the Akagi line and AP axis of the asymmetrical tibial tray, statistical differences were found between all lines (p < 0.05). The PLCL technique is principally suitable for Chinese patients requiring TKA when using the tibial component referred to in this study, although it may result in slight external rotation.

A Circumferentially Flanged Tibial Tray Minimizes Bone-Tray Shear Micromotion

2005 ◽  
Vol 219 (6) ◽  
pp. 449-456 ◽  
Author(s):  
D S Barker ◽  
K E Tanner ◽  
L Ryd
Keyword(s):  
Aseptic Loosening ◽  
Tibial Component ◽  
Proximal Tibia ◽  
Major Complication ◽  
Axial Loads ◽  
Element Analysis ◽  
Tibial Tray ◽  
Bone Removal ◽  
Theoretical Design ◽  
Total Knee

Aseptic loosening of the tibial component is the major complication of total knee arthroplasty. There is an association between early excessive shear micromotion between the bone and the tray of the tibial component and late aseptic loosening. Using non-linear finite element analysis, whether a tibial tray with a circumferentially flanged rim and a mating cut in the proximal tibia could minimize bone-tray shear micromotion was considered. fifteen competing tray designs with various degrees of flange curvature were assessed with the aim of minimizing bone-tray shear micromotion. A trade-off was found between reducing micromotion and increasing peripheral cancellous bone stresses. It was found that, within the limitations of the study, there was a theoretical design that could virtually eliminate micromotion due to axial loads, with minimal bone removal and without the use of screws or pegs.

Automated Virtual Placement and Evaluation of Tibial Components for Knee Arthroplasty

2011 ◽  
Author(s):  
Yifei Dai ◽  
Mary S. S. Wentorf ◽  
Jeffrey E. Bischoff
Keyword(s):  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Implant Design ◽  
Rotational Axis ◽  
Rotational Malalignment ◽  
Tibial Tray ◽  
Key Factor ◽  
Total Knee ◽  
The Impact ◽  
Good Coverage

The ability of tibial tray component shapes to appropriately fit boney geometry is an important aspect of implant design in total knee arthroplasty. Overhang of components in the knee has been associated with soft tissue damage and joint pain [1,2]. Good coverage establishes stability through adequate cortical bone support of the tray component, and reduces the likelihood of loosening and subsidence [3–5], and therefore serves as a key factor in component fixation, especially in those that rely on biological growth into porous component backings such as Trabecular Metal™ Material. More importantly, rotational malalignment of the tibial tray can disrupt the natural kinematics and implant longevity [6]. Previous studies investigated coverage of multiple tibial trays on digitized bone resection contours [1,7]. However the methodology for rotational alignment during implantation was not identified. Although rotational alignment has been investigated in numerous studies, most of the studies were carried out by either investigating the impact of malalignment [6], or assessing different definitions of the tibia rotational axis [8]. No correlation between the size of the rotational alignment window and the amount of coverage has been shown.

Analysis of the shape of the tibial tray in total knee arthroplasty using a three dimension finite element model

2002 ◽  
Vol 17 (7) ◽  
pp. 521-525 ◽  
Author(s):  
Shinya Miyoshi ◽  
Toshiaki Takahashi ◽  
Masahiro Ohtani ◽  
Hiroshi Yamamoto ◽  
Kanji Kameyama
Keyword(s):  
Finite Element ◽  
Total Knee Arthroplasty ◽  
Finite Element Model ◽  
Knee Arthroplasty ◽  
Element Model ◽  
Three Dimension ◽  
Tibial Tray ◽  
Total Knee

scholarly journals The surgeon plays an important role in size planning with patient specific instrumentation for total knee replacement.

10.29007/g13b ◽  
2018 ◽  
Author(s):  
Davide Cucchi ◽  
Riccardo Compagnoni ◽  
Paolo Ferrua ◽  
Alessandra Menon ◽  
Pietro Randelli
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Specific ◽  
Component Position ◽  
Careful Evaluation ◽  
Tibial Tray ◽  
Component Size ◽  
Patient Specific Instrumentation ◽  
Total Knee

Component position and sizing in total knee replacement (TKR) could be improved by patient specific instrumentation (PSI). The purpose of the study was to evaluate the reliability of the manufacturer plan in predicting final component sizes for TKR.Forty-five TKRs were prospectively enrolled and data on component size were recorded from the initial manufacturer’s proposal, the final plan modified after surgeon’s and from the actually implanted prostheses.Pre-operative modifications were required in more than 50% of the cases, with the tibial tray size requiring more frequent changes. The surgeon’s planning showed a significantly higher accuracy than the manufacturer’s one regarding tibial tray size (p &lt; 0.05) but not femoral components size (p: n.s.). Careful evaluation by an experienced knee surgeon is recommended when planning TKR with PSI.

Techniques for improving the initial strength of the tibial tray-cement interface bond

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 53-58 ◽  
Author(s):  
F. Billi ◽  
A. Kavanaugh ◽  
H. Schmalzried ◽  
T. P. Schmalzried
Keyword(s):  
Tibial Plateau ◽  
Surgical Techniques ◽  
Marrow Fat ◽  
Tibial Tray ◽  
Initial Strength ◽  
Cement Interface ◽  
Total Knee ◽  
The Mean ◽  
Interface Bond ◽  
Push Out

AimsLoosening of the tibial component after total knee arthroplasty (TKA) is a common indication for revision. Increasing the strength of the initial tibial implant/cement interface is desirable. There is little information about the surgical techniques that lead to the highest strength. We investigated the effects of eight variables on the strength of the initial tibial baseplate/cement interface.Materials and MethodsA total of 48 tibial trays were cemented into acrylic holders using cement from two manufacturers, at three different times (early, normal, and late) using two techniques: cementing the tibial plateau or the plateau and the keel; and involving two conditions of contamination with marrow fat (at the metal/cement and cement/cement interfaces). Push-out tests were performed with load continuously recorded.ResultsCompared with normal conditions, early cementing increased the mean strength of the interface when using the two cements, Simplex and Palacos, by 48% and 72%, respectively. Late cementing reduced the strength by 47% and 73%, respectively. Cementing the keel increased the mean strength by 153% and 147%, respectively, for the two cements. Contamination of the metal/cement interface with fat reduced the mean strength by 99% and 94% for the two cements but adding cement to the underside of the tibial tray prior to insertion resulted in the mean strength being lowered by only 65% and 43%, respectively.ConclusionIn order to maximize the strength of the tibial tray/cement interface, cement should be applied to the component soon after mixing, contamination of the interface should be avoided, and the keel and the plateau should be cemented.

Two-Dimensional Finite Element Analysis for Investigating Stresses Developed in Cement and Bone Layers in Total Knee Replacement

2018 ◽  
Vol 382 ◽  
pp. 181-185
Author(s):  
Usman ◽  
Shyh Chour Huang
Keyword(s):  
Finite Element ◽  
Cancellous Bone ◽  
Proximal Tibia ◽  
Compressive Strain ◽  
Von Mises Stress ◽  
Two Dimensional ◽  
Tibial Tray ◽  
Dimensional Finite Element ◽  
Total Knee ◽  
Von Mises

When a patient is undergoing a total knee arthroplasty, the proximal tibia is cut with a certain depth for tibial tray mounting. Moreover, the proximal tibia plateau is then drilled distally to create a hole where the tibial tray stem is inserted. Due to the existence of tibial tray stem stuck into the central part of the proximal tibia, the development of stress around the stem becomes the interesting parameter to be investigated, especially in the cement. For this purpose, a simplified two-dimensional finite element model has been created. The focus of the result analysis was fixed only on the knee bend activity load due to the highest von Mises stress occurred in this activity. The highest von Mises stress of 52.80 MPa occurred in the tibial tray, and then followed by the cortical bone, cement, central cancellous bone, and edge cancellous bone with von Mises stresses were 34.56, 5.40, 1.41, and 1.26 MPa, respectively. In the field of displacement and true strain in the cement, the highest resultant of displacement of 0.2mm occurred in the top section of the cement. Around the posterior tip, the cement experienced the tensile strain of 0.02 and around the anterior tip the strain was the compressive strain with similar value.

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