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Effects of Lower Limb Alignment and Tibial Component Inclination on the Biomechanics of lateral Compartment in Unicompartmental Knee Arthroplasty

引用

Chinese Medical Journal 2017年第21期130卷 2563-2568页

作者： Peng-Fei Wen Wan-Shou Guo Fu-Qiang Gao Qi-Dong Zhang Ju-An Yue Li-Ming Cheng Guang-Duo Zhu Peking University China-Japan Friendship School of Clinical Medicine Beijing 100029China Department of Orthopaedic Surgery Center for Osteonecrosis and Joint Preserving and ReconstructionBeijing Key Laboratory of Arthritic and Rheumatic DiseasesChina-Japan Friendship HospitalBeijing 100029China Beijing University of Chinese Medicine Beijing 100029China

Background： lateral compartmental osteoarthritis （LCOA）, a major complication after medial mobile-bearing unicompartmental knee arthroplasty （UKA）, is highly associated with the increased stress of the lateral compartment. This study aimed to analyze the effects on the stress and load distribution of the lateral compartment induced by lower limb alignment and coronal inclination of the tibial component in UKA through a finite element analysis. Methods： Eight three-dimensional models were constructed based on a validated model for analyzing the biomechanical effects of implantation parameters on the lateral compartment after medial Oxford UKA： postoperative lower limb alignment of 3° valgus, neutral and 3° varus, and the inclination of tibial components placed in 4°, 2° valgus, square, and 2° and 4° varus. The contact stress of femoral and tibial cartilage and load distribution were calculated for all models. Results： In the 3° valgus lower limb alignment model, the contact stress of femoral （3.38 MPa） and tibial （3.50 MPa） cartilage as well as load percentage （45.78%） was highest compared to any other model, and was increased by 36.75%, 47.70%, and 27.63%, respectively when compared to 3° varus. In the condition of a neutral position, the outcome was comparable for the different tibial tray inclination models. The inclination did not greatly affect the lateral compartmental stress and load distribution. Conclusions： This study suggested that slightly varus （undercorrection） lower limb alignment might be a way to prevent LCOAin medial mobile-bearing UKA. However, the inclination （4° varus to 4° valgus） of the tibial component in the coronal plane would not be a risk factor for LCOA in neutral position.

关键词： Finite Element Analysis lateral compartmental osteoarthritis Lower Limb Alignment Tibial Component Inclination Unicornpartmental Knee Arthroplasty

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