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Finite element assessment of block-augmented total knee arthroplasty.

Frehill, B, Crocombe, AD, Agarwal, Y and Bradley, WN (2015) Finite element assessment of block-augmented total knee arthroplasty. Comput Methods Biomech Biomed Engin, 18 (15). pp. 1726-1736.

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Loosening and migration of tibial prostheses have been identified as causes of early total knee replacement (TKR) failure. The problem is made more complex when defects occur in the proximal tibia compromising fixation and alignment. Clinical studies using metal augments have shown these to be an alternative to other means of defect treatment. Finite element (FE) analysis can be used to identify regions that may be prone to loosening and migration. In the current work, 3D FE models of TKR uncontained type-2 defects treated with block augments have been constructed and analysed. It has been shown that a metal augment is the most suitable. The use of bone cement (PMMA) to fill proximal defects is not considered suitable as stresses carried by the cement block exceed those of the fatigue limit of bone cement. It has been shown that the stresses in the proximal cancellous bone of block-augmented models are significantly below levels likely to cause damage due to overloading. Furthermore, the use of stem extensions has been shown to reduce the cancellous bone stresses in the proximal region thus increasing the likelihood of bone resorption. Given this, it is recommended that stem extensions are not required unless necessary to mitigate some other problem.

Item Type: Article
Divisions : Faculty of Engineering and Physical Sciences > Mechanical Engineering Sciences
Authors :
Date : 2015
Identification Number : 10.1080/10255842.2014.948429
Uncontrolled Keywords : cement augment, finite element analysis, metal augment, stem extension, total knee replacement
Related URLs :
Additional Information : This is an Author's Accepted Manuscript of an article published in Computer Methods in Biomechanics and Biomedical Engineering, 2014, copyright Taylor & Francis, available online at:
Depositing User : Symplectic Elements
Date Deposited : 01 Oct 2014 09:36
Last Modified : 09 Sep 2015 01:08

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