Ardestani, MM, Moazen, M, Maniei, E et al. (1 more author) (2015) Posterior stabilized versus cruciate retaining total knee arthroplasty designs: Conformity affects the performance reliability of the design over the patient population. Medical Engineering and Physics, 37 (4). pp. 350-360. ISSN 1350-4533
Abstract
Commercially available fixed bearing knee prostheses are mainly divided into two groups: posterior stabilized (PS) versus cruciate retaining (CR). Despite the widespread comparative studies, the debate continues regarding the superiority of one type over the other. This study used a combined finite element (FE) simulation and principal component analysis (PCA) to evaluate "reliability" and "sensitivity" of two PS designs versus two CR designs over a patient population. Four fixed bearing implants were chosen: PFC (DePuy), PFC Sigma (DePuy), NexGen (Zimmer) and Genesis II (Smith & Nephew). Using PCA, a large probabilistic knee joint motion and loading database was generated based on the available experimental data from literature. The probabilistic knee joint data were applied to each implant in a FE simulation to calculate the potential envelopes of kinematics (i.e. anterior–posterior [AP] displacement and internal–external [IE] rotation) and contact mechanics. The performance envelopes were considered as an indicator of performance reliability. For each implant, PCA was used to highlight how much the implant performance was influenced by changes in each input parameter (sensitivity). Results showed that (1) conformity directly affected the reliability of the knee implant over a patient population such that lesser conformity designs (PS or CR), had higher kinematic variability and were more influenced by AP force and IE torque, (2) contact reliability did not differ noticeably among different designs and (3) CR or PS designs affected the relative rank of critical factors that influenced the reliability of each design. Such investigations enlighten the underlying biomechanics of various implant designs and can be utilized to estimate the potential performance of an implant design over a patient population.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2015 IPEM. Published by Elsevier Ltd. All rights reserved. This is an author produced version of a paper published in Medical Engineering and Physics. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Total knee arthroplasty; Inter-patient variability; Stanmore knee simulator; Principal component analysis; Finite element simulation; Sensitivity |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Medical and Biological Engineering (iMBE) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 25 Apr 2016 14:58 |
Last Modified: | 04 Nov 2017 20:09 |
Published Version: | http://dx.doi.org/10.1016/j.medengphy.2015.01.008 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.medengphy.2015.01.008 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:92793 |