Biomechanical Effects of Stemmed Total Knee Arthroplasty on the Human Femur: A CT‐Data Based Study

Elisabeth M. Sporer; Christoph Schilling; Adrian Sauer; Robert J. Tait; Alexander Giurea; Thomas M. Grupp

doi:10.1155/2022/5738610

journal article Open Access Jan 01, 2022

Biomechanical Effects of Stemmed Total Knee Arthroplasty on the Human Femur: A CT‐Data Based Study

Elisabeth M. Sporer

Christoph Schilling Adrian Sauer Robert J. Tait Alexander Giurea Thomas M. Grupp

BioMed Research International Vol. 2022 No. 1 · Wiley

View at Publisher Save 10.1155/2022/5738610

Abstract

End‐of‐stem pain of the femur is a common problem in revision total knee arthroplasty (TKA). It may be caused by a problematic interaction between stem and bone, but the exact biomechanical correlate is still unknown. The aim of this prospective study was to find out how the stem is positioned in the medullary canal, how the femoral geometry changes due to implantation, and whether the results are influenced by the diameter of the trial. We implanted 16 rotating hinge knee implants into 16 fresh‐frozen human femora using the hybrid fixation technique and comparing two reaming protocols. We created 3‐dimensional models of the specimens before and after implantation using CT‐scans and calculated the differences. The main contact between stem and bone was found at the proximal 30 mm of the stem, especially anterior. We observed two different contact patterns of stem and bone. The cortical thickness was reduced especially at the anterior tip of the stem with a maximum reduction of 1405 ± 501 μm in the standard group and 980 ± 447 μm in the small_trial group, which is a relative reduction of 34 ± 14% (standard group) and 26 ± 14% (small_trial group). The bone experienced a deformation to posterior and lateral. We conclude that the tip of the stem is an important biomechanical region. Different contact patterns between stem and bone as well as the reduction in cortical thickness at the tip of the stem may play a role in the development of end‐of‐stem pain.

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Details

Published: Jan 01, 2022
Vol/Issue: 2022(1)
License: View

Authors

National Drug Research Institute, Faculty of Health Sciences Curtin University Perth WA Australia

Cite This Article

Elisabeth M. Sporer, Christoph Schilling, Adrian Sauer, et al. (2022). Biomechanical Effects of Stemmed Total Knee Arthroplasty on the Human Femur: A CT‐Data Based Study. BioMed Research International, 2022(1). https://doi.org/10.1155/2022/5738610

Biomechanical Effects of Stemmed Total Knee Arthroplasty on the Human Femur: A CT‐Data Based Study

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