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Tibial plate may mitigate post-TKA revision stem tip stress
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Researchers who used a 3-D finite element model of an implanted tibia to measure knee load after revision total knee arthroplasty with a locking compression plate found that use of the plate decreased stresses on the stem tip.
“From the analysis conducted it has been concluded that the attachment of a plate to the tibia has an impact on von Mises stress levels in the cancellous bone at the stem tip,” Christine L. Kimpton, BA, BAI, MSc, and colleagues, of Guilford, United Kingdom, wrote in their study. “In all the models, the plate reduced the volume of critically stressed cancellous bone at the stem tip, but the amount of reduction was dependent on stem extension type, plate attachment method, plate location and material used.”
Using the ABAQUS software, Kimpton and colleagues created a model with a cancellous bone section, cortical bone section, lower cement layer, top cement layer, a stem extension attached to a tibial tray and a mobile bearing. They used data from 14 normal adults to calculate the distribution of load on the lateral and medial condyles. The researchers then measured the plate attached to the tibia at 90 mm by 15 mm by 5 mm and placed it as close as possible to the diaphyseal area at the stem tip.
They found the von Mises stress levels were reduced in the model with the locking compression plate for the bone immediately beneath the plate, and further noted that the medial side of the knee showed the greatest reduction in von Mises stress levels.
Disclosure: The authors have no relevant financial disclosures.
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