The influence of UKA Installation Error of Joint Line on Contact Mechanics and Kinematics of Knee Joint
10.16156/j.1004-7220.2023.02.13
- VernacularTitle:UKA 关节线安装误差对膝关节接触力学和运动学影响
- Author:
Jiaxuan REN
1
;
Zhenxian CHEN
1
;
Jing ZHANG
1
;
Xuan ZHANG
1
;
Zhangwe MA
2
;
Zhongmin JIN
3
Author Information
1. School of Construction Machinery, Chang′ an University
2. Department of Orthopedic, Affiliated Hospital of Yan’an University
3. School of Mechanical Engineering, Southwest Jiaotong University
- Publication Type:Journal Article
- Keywords:
unicompartmental knee arthroplasty (UKA);
musculoskeletal multi-body dynamics;
joint line;
contact mechanics;
joint movement
- From:
Journal of Medical Biomechanics
2023;38(2):E290-E296
- CountryChina
- Language:Chinese
-
Abstract:
Objective Aiming at the medial prosthetic loosening failure and lateral cartilage degeneration after unicompartmental knee arthroplasty ( UKA), the effects of prosthetic installation errors of joint line in UKA on knee contact mechanics and kinematics during different physiologic activities were studied using musculoskeletal multi-body dynamic method. Methods Taking the medial natural joint line as 0 mm error, six installation errors ofjoint line including ±2 mm, ±4 mm and ±6 mm were considered respectively, and seven musculoskeletal multi body dynamic models of medial UKA were established, to comparatively study the variations in knee contact mechanics and kinematics during walking and squatting. Results At 70% of walking gait cycle, compared with 0 mm error, the medial prosthetic contact force was increased by 127. 3% and the contact force of the lateral cartilage was decreased by 12. 0% under 2 mm elevation in joint line, the medial prosthetic contact force was close to 0 N, but the lateral cartilage contact forces were increased by 10. 1% under 4 mm reduction in joint line. The tibiofemoral total contact forces were increased by 19. 7% and decreased by 14. 2% under 2 mm elevation and 2 mm reduction in joint line, respectively. At the 100°knee flexion during squatting, compared with 0 mm error, the medial prosthetic contact force and the tibiofemoral total contact force increased by 31. 6% and 11. 1% under 2 mm elevation in joint line, and decreased by 24. 5% and 8. 5% under 2 mm reduction in joint line, respectively. The change in the lateral cartilage contact force was not marked. Moreover, at 70% of walking gait cycle, the varus angle decreased, the internal rotation and the anterior translation increased along with the elevation of joint line in UKA, while it was just the opposite along with the reduction of joint line in UKA. The trends of the varus valgus movement and anterior-posterior translation during squatting were consistent with those during swing phase of walking, but the trend of the internal-external rotation was opposite. Conclusions In order to reduce the risk of medial prosthetic loosening failure and lateral cartilage degeneration, it is recommended that the installation error of joint line in UKA should be controlled in the range of -2 mm to +2 mm. This study provides theoretical basis for UKA clinical failure caused by changes in joint line
