"Therefore, rigid body constraints were applied in order to perform the finite element simulations of randomized geometries in a reasonable computational cost. (2) Although computational findings were in a good agreement with the available literature   , parts of the presented findings have not been reported elsewhere and further clinical investigations are required to test whether changes in the proposed dimensions can alleviate the competing effect of implant geometry on its performance metrics. Accordingly, various future directions from this study can be considered. "
"The latter approach enables us to generate large probabilistic databases representing the inherent variability of a patient population or to model the complicated interactions between input variables and output metrics in terms of sensitivity indices. The aforementioned studies however have mostly attempted to investigate PS designs   or CR designs   . To best of our knowledge, no previous computational study has compared PS versus CR in a systematic approach. "
[Show abstract][Hide abstract] ABSTRACT: Clinical studies demonstrate substantial variation in kinematic and functional performance within the total knee replacement (TKR) patient population. Some of this variation is due to differences in implant design, surgical technique and component alignment, while some is due to subject-specific differences in joint loading and anatomy that are inherently present within the population. Combined finite element and probabilistic methods were employed to assess the relative contributions of implant design, surgical, and subject-specific factors to overall tibiofemoral (TF) and patellofemoral (PF) joint mechanics, including kinematics, contact mechanics, joint loads, and ligament and quadriceps force during simulated squat, stance-phase gait and stepdown activities. The most influential design, surgical and subject-specific factors were femoral condyle sagittal plane radii, tibial insert superior-inferior (joint line) position and coronal plane alignment, and vertical hip load, respectively. Design factors were the primary contributors to condylar contact mechanics and TF anterior-posterior kinematics; TF ligament forces were dependent on surgical factors; and joint loads and quadriceps force were dependent on subject-specific factors. Understanding which design and surgical factors are most influential to TKR mechanics during activities of daily living, and how robust implant designs and surgical techniques must be in order to adequately accommodate subject-specific variation, will aid in directing design and surgical decisions towards optimal TKR mechanics for the population as a whole.
Journal of Biomechanics 06/2012; 45(12):2092-102. DOI:10.1016/j.jbiomech.2012.05.035 · 2.75 Impact Factor
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