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Initial stability of type-2 tibial defect treatments

Frehill, B, Crocombe, A, Cirovic, S, Agarwal, Y and Bradley, N (2010) Initial stability of type-2 tibial defect treatments PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, 224 (H1). 77 - 85. ISSN 0954-4119

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Abstract

Treatment of proximal tibial defects is important to the survival of tibial prosthesis after total knee replacement. The objective of this finite element study was to determine a better understanding of the stresses produced by different treatment options for moderate uncontained type-2 defects. Methods analysed were the use of metal wedges, metal blocks, cement wedges, and cement blocks for the two defect angles 15° and 30°. The effect of a stem extension on the stress profiles was also analysed for each defect treatment and angle to establish the necessity of these extensions and consequent bone removal on the stability of the augments. Equivalent stresses in two regions of interest (ROIs) adjacent to the augments and shear stresses along the bone—cement interface of the defect were investigated. The lowest equivalent stresses were found in the metal block augment for both defect angles and ROIs. The highest equivalent stress in the ROIs and shear stress values along the bone—cement interface of the defect were found in the cement wedge augment model for both defect angles. Stem extensions were shown to increase equivalent stresses in the bone closer to the tibial stem but to decrease equivalent stresses closer to the cortical bone. The use of a stem extension significantly increased the shear stresses in the cement in all cases except in the metal block model. It is recommended that metal block augments are used without a stem extension in small-defect (i.e. peripheral defect angle of 15°) total knee replacement procedures.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Journal Of Engineering In Medicine - Part H. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal Of Engineering In Medicine - Part H 224(1), January 2010, DOI 10.1243/09544119JEIM673
Uncontrolled Keywords: Science & Technology, Technology, Engineering, Biomedical, Engineering, total knee replacement, augment, stem extension, initial stability, TOTAL KNEE ARTHROPLASTY, BONE LOSS, MANAGEMENT, AUGMENTS, CONES, STEMS
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Divisions: Faculty of Engineering and Physical Sciences > Mechanical Engineering Sciences
Depositing User: Symplectic Elements
Date Deposited: 01 Oct 2012 18:43
Last Modified: 23 Sep 2013 19:38
URI: http://epubs.surrey.ac.uk/id/eprint/716728

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