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Finite element analysis of tibio-femoral contact mechanics of a customised knee spacer

Biosurface and Biotribology 2022年第2期8卷 121-128页

作者： Alex C.T.Choh andy yew Seng Jin Yeo Desmond Y.R.Chong Shi-Lu Chia Department of Orthopaedic Surgery Singapore General HospitalSingaporeSingapore Engineering Cluster Singapore Institute of TechnologySingaporeSingapore

With one-third of patients having osteoarthritis predominantly in one compartment of the knee,unicompartmental knee spacers have been introduced as a less invasive alternative to total knee ***,patients with the knee spacer implanted were seen to have persistent pain,resulting in high revision rates.A static finite element model of the knee and its interaction with a knee spacer implant at full extension and 90°flexion was used to investigate the tibio-femoral contact mechanics of the knee joint after a knee spacer *** different knee spacer designs(contoured,flat and C-shaped)were modelled and prescribed with cobalt-chrome,ultra-high molecular polyethylene and polyurethane material *** results suggested that a softer spacer is generally preferred as this helps in the conformity of knee spacer to the condyle,effectively distributing the load subjected to the *** spacers that result in high stresses resulting from lower contact areas should be avoided.

关键词： biomechanics contact pressure finite element analysis knee spacer

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Comparison of a simplified skin pointer device compared with a skeletal marker for knee rotation laxity: A cadaveric study using a rotation-meter

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World Journal of Orthopedics 2018年第6期9卷 85-91页

作者： Ken Lee Puah andy Khye Soon yew Siaw Meng Chou Denny Tijauw Tjoen Lie Department of Orthopaedic Surgery Singapore General Hospital Singapore General Hospital School of Mechanical and Aerospace Engineering College of Engineering Nanyang Technological University

AIM To compare the measurements of knee rotation laxity by non-invasive skin pointer with a knee rotation jig in cadaveric knees against a skeletally mounted marker. METHODS Six pairs of cadaveric legs were mounted on a knee rotation jig. One Kirscher wire was driven into the tibial tubercle as a bone marker and a skin pointer was attached. Rotational forces of 3, 6 and 9 nm applied at 0°, 30°, 45°, 60° and 90° of knee flexion were analysed using the Pearson correlation coefficient and paired t-test. RESULTS Total rotation recorded with the skin pointer significantly correlated with the bone marker at 3 nm at 0°(skin pointer 23.9 ± 26.0° vs bone marker 16.3 ± 17.3°, r = 0.92; P = 0.0), 30°(41.7 ± 15.5° vs 33.1 ± 14.7°, r = 0.63; P = 0.037), 45°(49.0 ± 17.0° vs 40.3 ± 11.2°, r = 0.81; P = 0.002), 60°(45.7 ± 17.5° vs 34.7 ± 9.5°, r = 0.86; P = 0.001) and 90°(29.2 ± 10.9° vs 21.2 ± 6.8°, r = 0.69; P = 0.019) of knee flexion and 6 nm at 0°(51.1 ± 37.7° vs 38.6 ± 30.1°, r = 0.90; P = 0.0), 30°(64.6 ± 21.6° vs 54.3 ± 15.1°, r = 0.73; P = 0.011), 45°(67.7 ± 20.6° vs 55.5 ± 9.5°, r = 0.65; P = 0.029), 60°(62.9 ± 22.4° vs 45.8 ± 13.1°,r = 0.65; P = 0.031) and 90°(43.6 ± 17.6° vs 31.0 ± 6.3°, r = 0.62; P = 0.043) of knee flexion and at 9 nm at 0°(69.7 ± 40.0° vs 55.6 ± 30.6°, r = 0.86; P = 0.001) and 60°(74.5 ± 27.6° vs 57.1 ± 11.5°, r = 0.77; P = 0.006). No statistically significant correlation with 9 nm at 30°(79.2 ± 25.1° vs 66.9 ± 15.4°, r = 0.59; P = 0.055), 45°(80.7 ± 24.7° vs 65.5 ± 11.2°, r = 0.51; P = 0.11) and 90°(54.7 ± 21.1° vs 39.4 ± 8.2°, r = 0.55; P = 0.079). We recognize that 9 nm of torque may be not tolerated in vivo due to pain. Knee rotation was at its maximum at 45° of knee flexion and increased with increasing *** The skin pointer and knee rotation jig can be a reliable and simple means of quantifying knee rotational laxity with future clinical application.

关键词： Rotatometer Rottometer Knee Laxity Cruciate Biomechanics Measurement

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Rotator cuff repair with an interposition polypropylene mesh:A biomechanical ovine study

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World Journal of Orthopedics 2023年第5期14卷 319-327页

作者： Winston Shang Rong Lim andy Khye Soon yew Hannah Lie Siaw Meng Chou Denny Tijauw Tjoen Lie Department of Orthopaedic Surgery Singapore General HospitalSingapore 169856Singapore College of Engineering Nanyang Technical UniversitySingapore 797101Singapore

BACKGROUND Chronic large to massive rotator cuff tears are difficult to treat and re-tears are common even after surgical *** propose using a synthetic polypropylene mesh to increase the tensile strength of rotator cuff *** hypothesize that using a polypropylene mesh to bridge the repair of large rotator cuff tears will increase the ultimate failure load of the *** To investigate the mechanical properties of rotator cuff tears repaired with a polypropylene interposition graft in an ovine ex-vivo *** A 20 mm length of infraspinatus tendon was resected from fifteen fresh sheep shoulders to simulate a large *** used a polypropylene mesh as an interposition graft between the ends of the tendon for *** seven specimens,the mesh was secured to remnant tendon by continuous stitching while mattress stitches were used for eight *** specimens with an intact tendon were *** specimens underwent cyclic loading to determine the ultimate failure load and gap *** The mean gap formation after 3000 cycles was 1.67 mm in the continuous group,and 4.16 mm in the mattress group(P=0.001).The mean ultimate failure load was significantly higher at 549.2 N in the continuous group,426.4 N in the mattress group and 370 N in the intact group(P=0.003).CONCLUSION The use of a polypropylene mesh is biomechanically suitable as an interposition graft for large irreparable rotator cuff tears.

关键词： Rotator cuff repair Massive tear Interposition graft Biomechanics Polypropylene mesh

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