Methods - Twelve replica tibiae were prepared for full-field optical surface strain analysis. They were either left intact, implanted with RTKA components with cemented intramedullary fixation stems, or implanted with a novel design with a tibial tray subframe supported by two extracortical fixation plates and screw fixation. They were loaded to simulate peak walking and stair climbing loads and the surface strains were measured using digital image correlation. The measurements were validated with strain gauge rosettes.
Results - Compared to the intact bone model, extracortical fixation reduced surface strain shielding by half versus intramedullary fixation. For all load cases and bone regions examined, the extracortical implant shielded 8 to 27% of bone strain, whereas the intramedullary component shielded 37 to 56%.
Conclusions - The new fixation design, which offers less bone destruction than conventional RTKA, also reduced strain-shielding. Clinically, this design may allow greater rebuilding of bone loss, and should increase long-term fixation.
- Wellcome Trust
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Data availability statement for 'Reduced tibial strain-shielding with extraosseous total knee arthroplasty revision system'.
Correa, T. (Creator), Pal, B. (Creator), van Arkel, R. (Creator), Vanacore, F. (Creator) & Amis, A. A. (Creator), Elsevier BV, 30 Sep 2018
Dataset: Data Availability Statement