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Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis

  • Authors:
    • Atichart Kwanyuang
    • Phachara Suklim
    • Khanin Iamthanaporn
    • Varah Yuenyongviwat
  • View Affiliations / Copyright

    Affiliations: Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand, Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
    Copyright: © Kwanyuang et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 47
    |
    Published online on: June 25, 2024
       https://doi.org/10.3892/mi.2024.171
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Abstract

Total knee arthroplasty faces challenges in the management of medial uncontained tibial defects, affecting prosthesis stability and implant survival. The use of screws and bone cement is a preferred approach; however, optimal screw insertion techniques lack consensus in the existing literature. The present study aimed to address this gap by exploring optimal screw and cement placement strategies, focusing on their biomechanical implications. The present study conducted a finite element analysis using a knee prosthesis model with a defined uncontained tibial defect. Various parameters were systematically adjusted, including the number of screws (1, 2 or 3 screws), screw lengths (10, 18, 30 or 40 mm), lateral‑medial screw positions (2, 4 or 6 mm laterally) and abduction rotation angles (0, 5, 10 or 15 degrees). These adjustments were made to evaluate their specific and combined impacts on the vertical displacement and abduction angles of the tibial tray. The results revealed that incorporating three‑screw reinforcement markedly reduced vertical displacement, while the single screw in the middle position exhibited superior performance in preventing the deformation of abduction angles compared to scenarios with two screws at anterior and posterior positions without a middle screw. Longer screws and smaller abduction angles contributed to decreased movement of the tibial component. Furthermore, the lateral adjustment of the screw position led to an increase in vertical displacement values, reaching ~1.5% when shifted 6 mm laterally. On the whole, the finite element analysis in the present study suggests that, for the treatment of medial uncontained tibial defects, three‑screw reinforcement is advantageous for larger defects. Longer screws and a smaller abduction angle are deemed favorable. Moreover, the results underscore the superiority of medial screw placement over lateral placement. It is imperative to note that further clinical validation is essential to corroborate the biomechanical implications observed herein.
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1 

Kim SE, Ro DH, Lee MC and Cholewa JM: Early- to mid-term review of a prospective, multi-center, international, outcomes study of an anatomically designed implant with posterior-stabilized bearing in total knee arthroplasty. Medicina (Kaunas). 59(2105)2023.PubMed/NCBI View Article : Google Scholar

2 

Alasaad H and Ibrahim J: Primary total knee arthroplasty in patients with a significant bone defect in the medial tibial plateau: Case series and literature review. Int J Surg Case Rep. 110(108779)2023.PubMed/NCBI View Article : Google Scholar

3 

Lei PF, Hu RY and Hu YH: Bone defects in revision total knee arthroplasty and management. Orthop Surg. 11:15–24. 2019.PubMed/NCBI View Article : Google Scholar

4 

Tang Q, Guo S, Deng W and Zhou Y: Using novel porous metal pillars for tibial bone defects in primary total knee arthroplasty. BMC Musculoskelet Disord. 24(829)2023.PubMed/NCBI View Article : Google Scholar

5 

Brooks PJ, Walker PS and Scott RD: Tibial component fixation in deficient tibial bone stock. Clin Orthop Relat Res. 302–308. 1984.PubMed/NCBI

6 

Engh GA and Ammeen DJ: Bone loss with revision total knee arthroplasty: Defect classification and alternatives for reconstruction. Instr Course Lect. 48:167–175. 1999.PubMed/NCBI

7 

Cuckler JM: Bone loss in total knee arthroplasty: Graft augment and options. J Arthroplasty. 19 (4 Suppl 1):S56–S58. 2004.PubMed/NCBI View Article : Google Scholar

8 

Rand JA: Bone deficiency in total knee arthroplasty. Use of metal wedge augmentation. Clin Orthop Relat Res. 63–71. 1991.PubMed/NCBI

9 

Whittaker JP, Dharmarajan R and Toms AD: The management of bone loss in revision total knee replacement. J Bone Joint Surg Br. 90:981–987. 2008.PubMed/NCBI View Article : Google Scholar

10 

Özcan Ö, Yeşil M, Yüzügüldü U and Kaya F: Bone cement with screw augmentation technique for the management of moderate tibial bone defects in primary knee arthroplasty patients with high body mass index. Jt Dis Relat Surg. 32:28–34. 2021.PubMed/NCBI View Article : Google Scholar

11 

Ritter MA: Screw and cement fixation of large defects in total knee arthroplasty. J Arthroplasty. 1:125–129. 1986.PubMed/NCBI View Article : Google Scholar

12 

Ritter MA, Keating EM and Faris PM: Screw and cement fixation of large defects in total knee arthroplasty. A sequel. J Arthroplasty. 8:63–65. 1993.PubMed/NCBI View Article : Google Scholar

13 

Berend ME, Ritter MA, Keating EM, Jackson MD and Davis KE: Use of screws and cement in primary TKA with up to 20 years follow-up. J Arthroplasty. 29:1207–1210. 2014.PubMed/NCBI View Article : Google Scholar

14 

Cinotti G, Perfetti F, Petitti P and Giannicola G: Primary complex total knee arthroplasty with severe varus deformity and large bone defects: Mid-term results of a consecutive series treated with primary implants. Eur J Orthop Surg Traumatol. 32:1045–1053. 2022.PubMed/NCBI View Article : Google Scholar

15 

Completo A, Rego A, Fonseca F, Ramos A, Relvas C and Simões JA: Biomechanical evaluation of proximal tibia behaviour with the use of femoral stems in revision TKA: An in vitro and finite element analysis. Clin Biomech (Bristol, Avon). 25:159–165. 2010.PubMed/NCBI View Article : Google Scholar

16 

Zhao Y, Robson Brown KA, Jin ZM and Wilcox RK: Trabecular level analysis of bone cement augmentation: A comparative experimental and finite element study. Ann Biomed Eng. 40:2168–2176. 2012.PubMed/NCBI View Article : Google Scholar

17 

Qiu YY, Yan CH, Chiu KY and Ng FY: Review article: Treatments for bone loss in revision total knee arthroplasty. J Orthop Surg (Hong Kong). 20:78–86. 2012.PubMed/NCBI View Article : Google Scholar

18 

Mancuso F, Beltrame A, Colombo E, Miani E and Bassini F: Management of metaphyseal bone loss in revision knee arthroplasty. Acta Biomed. 88:98–111. 2017.PubMed/NCBI View Article : Google Scholar

19 

Ritter MA and Harty LD: Medial screws and cement: A possible mechanical augmentation in total knee arthroplasty. J Arthroplasty. 19:587–589. 2004.PubMed/NCBI View Article : Google Scholar

20 

Zheng C, Ma HY, Du YQ, Sun JY, Luo JW, Qu DB and Zhou YG: Finite element assessment of the screw and cement technique in total knee arthroplasty. Biomed Res Int. 2020(3718705)2020.PubMed/NCBI View Article : Google Scholar

21 

Zhao G, Yao S, Ma J and Wang J: The optimal angle of screw for using cement-screw technique to repair tibial defect in total knee arthroplasty: A finite element analysis. J Orthop Surg Res. 17(363)2022.PubMed/NCBI View Article : Google Scholar

22 

Ma J, Xu C, Zhao G, Xiao L and Wang J: The optimal size of screw for using cement-screw technique to repair tibial defect in total knee arthroplasty: A finite element analysis. Heliyon. 9(e14182)2023.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Kwanyuang A, Suklim P, Iamthanaporn K and Yuenyongviwat V: Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis. Med Int 4: 47, 2024.
APA
Kwanyuang, A., Suklim, P., Iamthanaporn, K., & Yuenyongviwat, V. (2024). Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis. Medicine International, 4, 47. https://doi.org/10.3892/mi.2024.171
MLA
Kwanyuang, A., Suklim, P., Iamthanaporn, K., Yuenyongviwat, V."Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis". Medicine International 4.5 (2024): 47.
Chicago
Kwanyuang, A., Suklim, P., Iamthanaporn, K., Yuenyongviwat, V."Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis". Medicine International 4, no. 5 (2024): 47. https://doi.org/10.3892/mi.2024.171
Copy and paste a formatted citation
x
Spandidos Publications style
Kwanyuang A, Suklim P, Iamthanaporn K and Yuenyongviwat V: Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis. Med Int 4: 47, 2024.
APA
Kwanyuang, A., Suklim, P., Iamthanaporn, K., & Yuenyongviwat, V. (2024). Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis. Medicine International, 4, 47. https://doi.org/10.3892/mi.2024.171
MLA
Kwanyuang, A., Suklim, P., Iamthanaporn, K., Yuenyongviwat, V."Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis". Medicine International 4.5 (2024): 47.
Chicago
Kwanyuang, A., Suklim, P., Iamthanaporn, K., Yuenyongviwat, V."Biomechanical evaluation of screw and cement placement strategies for treating medial uncontained tibial defects in total knee arthroplasty: A finite element analysis". Medicine International 4, no. 5 (2024): 47. https://doi.org/10.3892/mi.2024.171
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