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Influence of an interpositional spacer on the behaviour of the tibiofemoral joint: a finite element study

Record type: Article

Background: interpositional arthroplasty is considered by many surgeons for the treatment of isolated medial compartment osteoarthritis of the knee. In this procedure, an interpositional spacer is inserted into the medial compartment of the joint with no bone resection and no mechanical fixation. Major problems such as implant dislocation, severe pain or need for revision have been reported post-operatively.
Methods: in this study, the kinematics of a knee implanted with an interpositional spacer made of either polyurethane or cobalt–chrome during walking, stair ascent and squatting cycles have been predicted and compared to the normal knee using finite element analysis. In addition, articular cartilage stress histories have been examined to obtain distributions of cumulative stress, a measure of the likelihood of articular cartilage degeneration.
Findings: the insertion of a polyurethane interpositional spacer in the medial side of the knee did not affect knee kinematics as compared to the normal knee, but caused an increase of articular cartilage cumulative contact stress exposures in the medial compartment of the joint. The knee implanted with the Co–Cr spacer exhibited similar trends in knee kinematics, however significantly different ranges of motion were observed during some periods of the activity cycles, specifically during the first half of the walking cycle where lower ranges of motion were predicted. In addition, higher articular cartilage cumulative contact stress exposures were observed in both compartments of the knee. In both cases, cumulative contact stress exposures of the tibial articular cartilage were more affected than those of the femoral articular cartilage.
Interpretation: these results suggest implant material as an important parameter in the design phase of interpositional spacers

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Citation

Checa, S., Taylor, M. and New, A. (2008) Influence of an interpositional spacer on the behaviour of the tibiofemoral joint: a finite element study Clinical Biomechanics, 23, (8), pp. 1044-1052. (doi:10.1016/j.clinbiomech.2008.04.006).

More information

Published date: October 2008
Keywords: finite element method, interpositional arthroplasty, cartilage contact stress exposure, articular cartilage degeneration

Identifiers

Local EPrints ID: 72155
URI: http://eprints.soton.ac.uk/id/eprint/72155
ISSN: 0268-0033
PURE UUID: fb14c741-e536-4fae-a58b-523ebe25be55

Catalogue record

Date deposited: 26 Jan 2010
Last modified: 18 Jul 2017 23:55

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Contributors

Author: S. Checa
Author: M. Taylor
Author: A. New

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