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. 2018 May 16;13(1):113.
doi: 10.1186/s13018-018-0830-1.

Finite element analysis of the tibial bone graft in cementless total knee arthroplasty

Koji Totoribe  1 , Etsuo Chosa  2 , Go Yamako  3 , Hiroaki Hamada  2 , Koki Ouchi  3 , Shutaro Yamashita  3 , Gang Deng  3
Affiliations

Finite element analysis of the tibial bone graft in cementless total knee arthroplasty

Koji Totoribe et al. J Orthop Surg Res. .

Abstract

Background: Achieving stability of the tibial implant is essential following cementless total knee arthroplasty with bone grafting. We investigated the effects of bone grafting on the relative micromotion of the tibial implant and stress between the tibial implant and adjacent bone in the immediate postoperative period.

Methods: Tibial implant models were developed using a nonlinear, three-dimensional, finite element method. On the basis of a preprepared template, several bone graft models of varying sizes and material properties were prepared.

Results: Micromotion was larger in the bone graft models than in the intact model. Maximum micromotion and excessive stress in the area adjacent to the bone graft were observed for the soft and large graft models. With hard bone grafting, increased load transfer and decreased micromotion were observed.

Conclusions: Avoidance of large soft bone grafts and use of hard bone grafting effectively reduced micromotion and undue stress in the adjacent area.

Keywords: Bone graft; Finite element analysis; Total knee arthroplasty.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the University of Miyazaki.

Informed consent to participate in the study was obtained from the participant.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Detailed finite element model of the proximal tibia and tibial component. The directions of the axes of the global coordinate system are shown. a Intact tibia showing the contact surface with the tibial component. b UHMWPE insert. c Tibial baseplate with keel. d Load application to the model
Fig. 2
Fig. 2
Finite element models of bone grafts. Posterolateral view of the bone graft area. a Large, b medium, and c small bone defects filled with bone graft
Fig. 3
Fig. 3
Resultant displacement of the deformed tibial tray under maximum loading in each model. Contour lines of deformation indicate deformation of the tibial tray. Magnification factor of the displacement × 10. a I (intact). b L–S (large), c M–S (medium), and d S–S (small) bone grafts with soft bone. e L–H (large), f M–H (medium), and g S–H (small) bone grafts with hard bone
Fig. 4
Fig. 4
Maximum liftoff of the tibial tray in each model. I (intact), L–S (large), M–S (medium), and S–S (small) bone grafts with soft bone. L–H (large), M–H (medium), and S–H (small) bone grafts with hard bone
Fig. 5
Fig. 5
Relative micromotion beneath the stem in each model. I (intact), L–S (large), M–S (medium), and S–S (small) bone grafts with soft bone. L–H (large), M–H (medium), and S–H (small) bone grafts with hard bone
Fig. 6
Fig. 6
Top view of von Mises stress distribution on the contact surface of the tibia under maximum loading. a I (intact). b L–S (large bone graft with soft bone). c M–S (medium bone graft with soft bone). d S–S (small bone graft with soft bone). e L–H (large bone graft with hard bone). f M–H (medium bone graft with hard bone). g S–H (small bone graft with hard bone)
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