The Journal of Bone and Joint Surgery, Vol 64, Issue 1 129-135, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
A comparative evaluation of tibial component designs of total knee prostheses
JL Lewis, MJ Askew and DP Jaycox
Three-dimensional finite-element stress analyses were used to compare the
fixation of tibial component configurations of surface-replacement-type
total knee prostheses, bases on the stresses in the cancellous bone, in the
polymethylmethacrylate, and at the bone cement-bone interface. The results
indicate that, in general, metal components provide lower system stresses
than polyethylene components, particularly in the methacrylate and the
cancellous bone, and that one-piece designs give lower bone cement-bone
interface stresses compared with those with separated condylar components.
Of the designs considered, a single-post, metal-backed design provided the
lowest system stresses over-all. Clinical Relevance: a great and confusing
variety of tibial component design exists today, with more in the process
of development. Short of long term clinical trials, there are few objective
methods by which these designs can be evaluated and long-term performance
predicted. There is evidence from clinical results that excessively high
stresses in the systems can lead to loosening of the tibial component. The
finite-element method provides a method for comparing prosthetic designs
using system stresses a s a design criterion. On this basis, we analyzed
the stress distribution for several types of tibial components and discuss
the advantages and disadvantages of their designs.
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