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Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties

Background and Objectives: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration offering sufficient...

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Autores principales: Filip, Alexandru Cristian, Cuculici, Stefan Alexandru, Cristea, Stefan, Filip, Viviana, Negrea, Alexis Daniel, Mihai, Simona, Pantu, Cosmin Marian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146833/
https://www.ncbi.nlm.nih.gov/pubmed/35630051
http://dx.doi.org/10.3390/medicina58050634
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author Filip, Alexandru Cristian
Cuculici, Stefan Alexandru
Cristea, Stefan
Filip, Viviana
Negrea, Alexis Daniel
Mihai, Simona
Pantu, Cosmin Marian
author_facet Filip, Alexandru Cristian
Cuculici, Stefan Alexandru
Cristea, Stefan
Filip, Viviana
Negrea, Alexis Daniel
Mihai, Simona
Pantu, Cosmin Marian
author_sort Filip, Alexandru Cristian
collection PubMed
description Background and Objectives: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration offering sufficient stability and good long-term survivorship. The following question arises: which situation requires the use of a standard configuration implant (without a stem) and which situation requires using the extension? Materials and Methods: The opportunity to use the tibial extension in the primary TKA was analyzed in correlation to the tibial bone structural properties. Using finite elements (FEs), the virtual model of the tibial bone was connected to that of the prosthetic implant, with and without a stem, and its behavior was analyzed during static and dynamic stresses, both in the situation in which the bone had normal physical properties, as well as in the case in which the bone had diminished physical properties. Results: The maximum stress and displacement values in the static compression regime show that adding a stem is only beneficial to structurally altered bone. Compression fatigue was reduced to almost half in the case of altered bone when adding a stem. Dynamic compression showed slightly better results with the tibial stem in both healthy and degraded bone. Conclusions: It was concluded that, if the bone is healthy and has good structural properties, it is not necessary to use the tibial extension in the primary operation; and if the bone has diminished physical properties, it is necessary to use the tibial extension at the primary operation, enhancing the stability, fixation, and implant lifespan.
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spelling pubmed-91468332022-05-29 Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties Filip, Alexandru Cristian Cuculici, Stefan Alexandru Cristea, Stefan Filip, Viviana Negrea, Alexis Daniel Mihai, Simona Pantu, Cosmin Marian Medicina (Kaunas) Article Background and Objectives: This study’s purpose was to examine the benefit of using a tibial extension in the primary operation of total knee arthroplasty (TKA). This is important because it is not a common practice to use the extension in a primary TKA, a standard configuration offering sufficient stability and good long-term survivorship. The following question arises: which situation requires the use of a standard configuration implant (without a stem) and which situation requires using the extension? Materials and Methods: The opportunity to use the tibial extension in the primary TKA was analyzed in correlation to the tibial bone structural properties. Using finite elements (FEs), the virtual model of the tibial bone was connected to that of the prosthetic implant, with and without a stem, and its behavior was analyzed during static and dynamic stresses, both in the situation in which the bone had normal physical properties, as well as in the case in which the bone had diminished physical properties. Results: The maximum stress and displacement values in the static compression regime show that adding a stem is only beneficial to structurally altered bone. Compression fatigue was reduced to almost half in the case of altered bone when adding a stem. Dynamic compression showed slightly better results with the tibial stem in both healthy and degraded bone. Conclusions: It was concluded that, if the bone is healthy and has good structural properties, it is not necessary to use the tibial extension in the primary operation; and if the bone has diminished physical properties, it is necessary to use the tibial extension at the primary operation, enhancing the stability, fixation, and implant lifespan. MDPI 2022-05-02 /pmc/articles/PMC9146833/ /pubmed/35630051 http://dx.doi.org/10.3390/medicina58050634 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Filip, Alexandru Cristian
Cuculici, Stefan Alexandru
Cristea, Stefan
Filip, Viviana
Negrea, Alexis Daniel
Mihai, Simona
Pantu, Cosmin Marian
Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title_full Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title_fullStr Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title_full_unstemmed Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title_short Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties
title_sort tibial stem extension versus standard configuration in total knee arthroplasty: a biomechanical assessment according to bone properties
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146833/
https://www.ncbi.nlm.nih.gov/pubmed/35630051
http://dx.doi.org/10.3390/medicina58050634
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