Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study

Abstract Background This study aims to clarify the combined influence of the tibial rotational alignment and posterior slope on knee joint biomechanics after posterior-stabilized total knee arthroplasty using a computer simulation. Methods Computer tomographic and magnetic resonance imaging scan of...

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Main Authors: Long Shao, Xiangdong Wu, Chaohua Fang, Hongli Zhu, Kun Tao, Shicheng Wang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:European Journal of Medical Research
Subjects:
Online Access:https://doi.org/10.1186/s40001-025-02747-5
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author Long Shao
Xiangdong Wu
Chaohua Fang
Hongli Zhu
Kun Tao
Shicheng Wang
author_facet Long Shao
Xiangdong Wu
Chaohua Fang
Hongli Zhu
Kun Tao
Shicheng Wang
author_sort Long Shao
collection DOAJ
description Abstract Background This study aims to clarify the combined influence of the tibial rotational alignment and posterior slope on knee joint biomechanics after posterior-stabilized total knee arthroplasty using a computer simulation. Methods Computer tomographic and magnetic resonance imaging scan of a healthy volunteer were used to reconstruct a detailed 3D geometrical model. A virtual surgery was performed to generate a resection plane with different posterior slopes and rotational alignment on the proximal tibia. The internal, neutral and external rotation, combined with a posterior slope of 0, 3, 5, and 7 degrees were simulated for both standing and bending position. The differences in contact pressure, area and stress of polyethene liner and the tensile stress of the soft tissue were compared. Results The contact area on the polyethylene liner decreased with increasing posterior slope in a standing position while the opposite trend was found in a bending position. In a bending position, internal rotation of tibial component resulted in smaller contact areas than neutral or external rotation. A posterior slope of 0° combined with neutral rotation in a standing position showed the smallest pressure on the liner with biggest contact area. The distribution of von Mises stress was more uniform with 0° and 3° than 5° and 7° posterior tibial slope for both standing and bending position. The stress increased with increasing posterior slope in both standing and bending position, ranging from 8.77 MPa to 79.39 MPa. The ligament and muscle tensile stress increased with increasing posterior slope in both standing and bending position. In addition, the neutral rotation showed lower maximum stress compared with other rotational alignment in a standing position. Conclusions An increased posterior slope increases the contact pressure and stress of the polyethene liner and the ligament tensile stress. A neutral rotation combined with a posterior slope of less than 3° showed superior biomechanical results in posterior-stabilized TKA.
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spelling doaj-art-99bc8899f2e04743b4366a72e0f2bad12025-08-20T03:45:10ZengBMCEuropean Journal of Medical Research2047-783X2025-06-0130111110.1186/s40001-025-02747-5Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element studyLong Shao0Xiangdong Wu1Chaohua Fang2Hongli Zhu3Kun Tao4Shicheng Wang5Joint and Sports Medicine Center, Ningbo No.6 HospitalDepartment of Orthopaedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, National Center for OrthopaedicsJoint and Sports Medicine Center, Ningbo No.6 HospitalTechnology Department, Chongqing Optical Machinery Research InstituteJoint and Sports Medicine Center, Ningbo No.6 HospitalJoint and Sports Medicine Center, Ningbo No.6 HospitalAbstract Background This study aims to clarify the combined influence of the tibial rotational alignment and posterior slope on knee joint biomechanics after posterior-stabilized total knee arthroplasty using a computer simulation. Methods Computer tomographic and magnetic resonance imaging scan of a healthy volunteer were used to reconstruct a detailed 3D geometrical model. A virtual surgery was performed to generate a resection plane with different posterior slopes and rotational alignment on the proximal tibia. The internal, neutral and external rotation, combined with a posterior slope of 0, 3, 5, and 7 degrees were simulated for both standing and bending position. The differences in contact pressure, area and stress of polyethene liner and the tensile stress of the soft tissue were compared. Results The contact area on the polyethylene liner decreased with increasing posterior slope in a standing position while the opposite trend was found in a bending position. In a bending position, internal rotation of tibial component resulted in smaller contact areas than neutral or external rotation. A posterior slope of 0° combined with neutral rotation in a standing position showed the smallest pressure on the liner with biggest contact area. The distribution of von Mises stress was more uniform with 0° and 3° than 5° and 7° posterior tibial slope for both standing and bending position. The stress increased with increasing posterior slope in both standing and bending position, ranging from 8.77 MPa to 79.39 MPa. The ligament and muscle tensile stress increased with increasing posterior slope in both standing and bending position. In addition, the neutral rotation showed lower maximum stress compared with other rotational alignment in a standing position. Conclusions An increased posterior slope increases the contact pressure and stress of the polyethene liner and the ligament tensile stress. A neutral rotation combined with a posterior slope of less than 3° showed superior biomechanical results in posterior-stabilized TKA.https://doi.org/10.1186/s40001-025-02747-5Biomechanical analysisTotal knee arthroplastyTibial componentRotational alignmentPosterior slopeComputational simulation
spellingShingle Long Shao
Xiangdong Wu
Chaohua Fang
Hongli Zhu
Kun Tao
Shicheng Wang
Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
European Journal of Medical Research
Biomechanical analysis
Total knee arthroplasty
Tibial component
Rotational alignment
Posterior slope
Computational simulation
title Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
title_full Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
title_fullStr Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
title_full_unstemmed Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
title_short Effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior-stabilized total knee arthroplasty: a finite element study
title_sort effect of tibial rotational alignment and posterior slope on joint biomechanics in posterior stabilized total knee arthroplasty a finite element study
topic Biomechanical analysis
Total knee arthroplasty
Tibial component
Rotational alignment
Posterior slope
Computational simulation
url https://doi.org/10.1186/s40001-025-02747-5
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