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. 2019 Nov 18:19:1-8.
doi: 10.1016/j.jor.2019.11.021. eCollection 2020 May-Jun.

Finite element assessment of metaphyseal sleeves in total knee arthroplasty

B Frehill  1 , A D Crocombe  1
Affiliations

Finite element assessment of metaphyseal sleeves in total knee arthroplasty

B Frehill et al. J Orthop. .

Erratum in

Abstract

This paper investigates the need to use stems in conjunction with cementless metaphyseal sleeves in total knee replacement (TKR) to treat cavity type-3 defects. Finite element models of TKR with type-3 defects of two sizes were modelled with and without stems. The use of sleeves result in stress concentrations at the bone/sleeve interface. The use of stems shows a reduction in these stresses but also an increased risk of bone resorption in the proximal tibia. Based on this investigation the authors recommend that stems are not required in TKR with cementless metaphyseal sleeves.

Keywords: Finite element analysis; Metaphyseal sleeves; Total knee replacement.

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Figures

Fig. 1
Fig. 1
Large metaphyseal sleeve (DePuy Synthes, Warsaw, IN).
Fig. 2
Fig. 2
Section cut in the frontal of the (a) SMS, (b) SMP, (c) LMS and (d) LMP TKR models.
Fig. 3
Fig. 3
TKR model meshed assembly.
Fig. 4
Fig. 4
TKR model assembly showing pressure load applied and constraints.
Fig. 5
Fig. 5
Load distribution along the z-axis in the standard non-sleeve model.
Fig. 6
Fig. 6
Load distribution along the z-axis in the SMS and LMS models.
Fig. 7
Fig. 7
Load distribution along the z-axis in the SMP and LMP models.
Fig. 8
Fig. 8
Von Mises stress distribution of the metaphyseal sleeve used for (a) SMS (b) SMP (c) LMS and (d) LMP models.
Fig. 9
Fig. 9
Von Mises (proximal view) stress distribution of the cancellous bone for (a) SMS (b) SMP (c) LMS (d) and LMP models.
Fig. 10
Fig. 10
Von Mises (section view) stress distribution of the cancellous bone for (a) SMS (b) SMP (c) LMS and (d) LMP.
Fig. 11
Fig. 11
Von Mises stress distribution of the cancellous bone for the standard non-sleeve model.
See this image and copyright information in PMC

References

    1. Agarwal S., Neogi D.S., Morgan-Jones R. Metaphyseal sleeves in revision total knee arthroplasty: minimum seven-year follow-up study. The Knee. 2018;25(6):1299–1307. - PubMed
    1. Dalury D.F., Barrett W.P. The use of metaphyseal sleeves in revision total knee arthroplasty. The Knee. 2016;23(3):545–548. - PubMed
    1. Radnay C.S., Scuderi G.R. Management of bone loss: augments, cones, offset stems. Clin Orthop Relat Res. 2006;446:83–92. - PubMed
    1. Lachiewicz P.F., Bolognesi M.P., Henderson R.A., Soileau E.S., Vail T.P. Can tantalum cones provide fixation in complex revision knee arthroplasty? Clin Orthop Relat Res. 2012;470(1):199–204. - PMC - PubMed
    1. Bugler K.E., Maheshwari R., Ahmed I., Brenkel I.J., Walmsley P.J. Metaphyseal sleeves for revision total knee arthroplasty: good short-term outcomes. J Arthroplast. 2015;30(11):1990–1994. - PubMed

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