Compliant Tibial Stem for Primary Total Knee Arthroplasty

Objective: Total knee arthroplasty (TKA) is a common and highly successful treatment for knee osteoarthritis. Despite its success, some TKA implants still do not last the remaining lifetime of the patient, due in large part to aseptic loosening of the bone-implant interface, most commonly involving...

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Main Authors: Armin W. Pomeroy, Alexander Upfill-Brown, Brandon T. Peterson, Dean Chen, Joel Weisenburger, Alexandra Stavrakis, Hani Haider, Nelson F. SooHoo, Jonathan B. Hopkins, Tyler R. Clites
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Journal of Translational Engineering in Health and Medicine
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Online Access:https://ieeexplore.ieee.org/document/11119545/
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author Armin W. Pomeroy
Alexander Upfill-Brown
Brandon T. Peterson
Dean Chen
Joel Weisenburger
Alexandra Stavrakis
Hani Haider
Nelson F. SooHoo
Jonathan B. Hopkins
Tyler R. Clites
author_facet Armin W. Pomeroy
Alexander Upfill-Brown
Brandon T. Peterson
Dean Chen
Joel Weisenburger
Alexandra Stavrakis
Hani Haider
Nelson F. SooHoo
Jonathan B. Hopkins
Tyler R. Clites
author_sort Armin W. Pomeroy
collection DOAJ
description Objective: Total knee arthroplasty (TKA) is a common and highly successful treatment for knee osteoarthritis. Despite its success, some TKA implants still do not last the remaining lifetime of the patient, due in large part to aseptic loosening of the bone-implant interface, most commonly involving the tibial component. In this manuscript, we present a compliant tibial stem with the potential to increase the lifespan of TKA by accommodating rotation of the tibial tray about the tibia’s long axis without introducing an additional high-cycle-count wear surface. Our objective was to refine the design of this implant to support the loads and displacements associated with common activities of daily living (ADLs), and to validate performance of a physical prototype on the benchtop. Methods: We used finite element analysis to sweep a representative parameter space of reasonably-sized caged hinges, and then to refine the mechanism geometry in the context of in vivo knee joint loads. We fabricated a prototype of the refined mechanism, and evaluated performance of that physical prototype under ADL loads and displacements. Results: The refined mechanism supports walking loads and displacements with a safety factor of 1.47 on the target fatigue stress limit. The maximum reaction moment in the prototype was 1.22 Nm during emulated walking, which represents a reduction of approximately 80% from the in vivo reaction moment within a conventional TKA implant rotating to the same angle. Discussion/Conclusion: Our results demonstrate feasibility of a compliant tibial stem with the potential to decrease failure rates and increase longevity of TKA implants.
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spelling doaj-art-acecea7315b14a9dabcf209e553ea5f52025-08-20T03:03:02ZengIEEEIEEE Journal of Translational Engineering in Health and Medicine2168-23722025-01-011337638610.1109/JTEHM.2025.359656111119545Compliant Tibial Stem for Primary Total Knee ArthroplastyArmin W. Pomeroy0https://orcid.org/0009-0007-0692-0536Alexander Upfill-Brown1Brandon T. Peterson2https://orcid.org/0000-0002-3785-745XDean Chen3https://orcid.org/0000-0001-9527-7720Joel Weisenburger4Alexandra Stavrakis5https://orcid.org/0000-0002-2391-7650Hani Haider6Nelson F. SooHoo7https://orcid.org/0000-0002-3943-2631Jonathan B. Hopkins8https://orcid.org/0000-0003-4752-746XTyler R. Clites9https://orcid.org/0000-0001-7754-4442Department of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USADepartment of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USADepartment of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USADepartment of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USADepartment of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE, USADepartment of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USADepartment of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE, USADepartment of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA, USADepartment of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USADepartment of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USAObjective: Total knee arthroplasty (TKA) is a common and highly successful treatment for knee osteoarthritis. Despite its success, some TKA implants still do not last the remaining lifetime of the patient, due in large part to aseptic loosening of the bone-implant interface, most commonly involving the tibial component. In this manuscript, we present a compliant tibial stem with the potential to increase the lifespan of TKA by accommodating rotation of the tibial tray about the tibia’s long axis without introducing an additional high-cycle-count wear surface. Our objective was to refine the design of this implant to support the loads and displacements associated with common activities of daily living (ADLs), and to validate performance of a physical prototype on the benchtop. Methods: We used finite element analysis to sweep a representative parameter space of reasonably-sized caged hinges, and then to refine the mechanism geometry in the context of in vivo knee joint loads. We fabricated a prototype of the refined mechanism, and evaluated performance of that physical prototype under ADL loads and displacements. Results: The refined mechanism supports walking loads and displacements with a safety factor of 1.47 on the target fatigue stress limit. The maximum reaction moment in the prototype was 1.22 Nm during emulated walking, which represents a reduction of approximately 80% from the in vivo reaction moment within a conventional TKA implant rotating to the same angle. Discussion/Conclusion: Our results demonstrate feasibility of a compliant tibial stem with the potential to decrease failure rates and increase longevity of TKA implants.https://ieeexplore.ieee.org/document/11119545/Orthopaedicsjoint replacementcompliant mechanismsimplantsknee osteoarthritis
spellingShingle Armin W. Pomeroy
Alexander Upfill-Brown
Brandon T. Peterson
Dean Chen
Joel Weisenburger
Alexandra Stavrakis
Hani Haider
Nelson F. SooHoo
Jonathan B. Hopkins
Tyler R. Clites
Compliant Tibial Stem for Primary Total Knee Arthroplasty
IEEE Journal of Translational Engineering in Health and Medicine
Orthopaedics
joint replacement
compliant mechanisms
implants
knee osteoarthritis
title Compliant Tibial Stem for Primary Total Knee Arthroplasty
title_full Compliant Tibial Stem for Primary Total Knee Arthroplasty
title_fullStr Compliant Tibial Stem for Primary Total Knee Arthroplasty
title_full_unstemmed Compliant Tibial Stem for Primary Total Knee Arthroplasty
title_short Compliant Tibial Stem for Primary Total Knee Arthroplasty
title_sort compliant tibial stem for primary total knee arthroplasty
topic Orthopaedics
joint replacement
compliant mechanisms
implants
knee osteoarthritis
url https://ieeexplore.ieee.org/document/11119545/
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