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Total and partial knee replacement implants that maintain native load transfer in the Tibia

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2046-3758.112.bjr-2021-0304.r1.pdfPublished version1.98 MBAdobe PDFView/Open
Title: Total and partial knee replacement implants that maintain native load transfer in the Tibia
Authors: Munford, M
Liddle, A
Stoddart, J
Cobb, J
Jeffers, J
Item Type: Journal Article
Abstract: Aims: Unicompartmental and total knee arthroplasty (UKA and TKA) are successful treatments for osteoarthritis, but the solid metal implants disrupt the natural distribution of stress and strain which can lead to bone loss over time. This generates problems if the implant needs to be revised. This study investigates whether titanium lattice UKA and TKA implants can maintain natural load transfer in the proximal tibia. Methods: In a cadaveric model, UKA and TKA procedures were performed on 8 fresh-frozen knee specimens, using conventional (solid) and titanium lattice tibial implants. Stress at the bone-implant interfaces were measured and compared to the native knee. Results: Titanium lattice implants were able to restore the mechanical environment of the native tibia for both UKA and TKA designs. Maximum stress at the bone-implant interface ranged from 1.2-3.3 MPa compared to 1.3-2.7 MPa for the native tibia. The conventional solid UKA and TKA implants reduced the maximum stress in the bone by a factor of 10 and caused >70% of bone surface area to be underloaded compared to the native tibia. Conclusions: Titanium lattice implants maintained the natural mechanical loading in the proximal tibia after UKA and TKA, but conventional solid implants did not. This is an exciting first step towards implants that maintain bone health, but such implants also have to meet fatigue and micromotion criteria to be clinically viable.
Issue Date: 16-Feb-2022
Date of Acceptance: 6-Dec-2021
URI: http://hdl.handle.net/10044/1/93204
DOI: 10.1302/2046-3758.112.BJR-2021-0304.R1
ISSN: 2046-3758
Publisher: The British Editorial Society of Bone & Joint Surgery
Start Page: 1
End Page: 3
Journal / Book Title: Bone and Joint Research
Volume: 11
Issue: 2
Copyright Statement: © 2022 Author(s) et al.Open Access This article is distributed under the terms of the Creative Commons Attributions (CC BY 4.0) licence (https://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original author and source are credited.
Sponsor/Funder: Engineering & Physical Science Research Council (EPSRC)
Wellcome Trust
Engineering & Physical Science Research Council (EPSRC)
National Institute for Health Research
Funder's Grant Number: EP/K027549/1
208858/Z/17/Z
EP/R042721/1
NIHR300013
Keywords: Additive manufacturing
Bone strain
Porous implants
bone-implant
cadaveric study
knee
knee arthroplasty implants
proximal tibia
tibial bone
tibial implants
titanium
total knee arthroplasty (TKA)
unicompartmental knee arthroplasty (UKA)
1103 Clinical Sciences
1106 Human Movement and Sports Sciences
Publication Status: Published
Online Publication Date: 2022-02-16
Appears in Collections:Mechanical Engineering
Department of Surgery and Cancer
Faculty of Medicine
Faculty of Engineering



This item is licensed under a Creative Commons License Creative Commons