PROXIMAL TIBIAL STRAIN DISTRIBUTION AFTER MOBILE AND FIXED BEARING TOTAL KNEE ARTHROPLASTY (TKA)

Abstract

This study investigated the difference in proximal tibial cortical strain distribution using a fixed or mobile bearing design for TKA.

Eight fresh frozen human cadaver tibias were used. The strain magnitude and distribution on the anterior cortex of the proximal tibia during axial and rotational loading of the knee were measured with a quantitative full-field strain measurement technique (Electronic Speckle Pattern Interferometry). First, strain distributions of the intact knee were acquired. Subsequently, strain distributions after implantation of conventional and mobile bearing PCL retaining total knee implants (Scorpio®) were measured

Under each loading condition, the minimum principal strain was greater in magnitude as compared to the maximum principal strain. Under 1,500 N axial loading, the resulting minimum principal strain magnitude and orientation was nearly identical between the mobile bearing configuration(500 ± 287m;e;), and the fixed bearing configuration (500 ± 286m;e;). In response to 10° internal rotation, this strain increased to 782 ± 371m;e; and 1000± 389m;e; for the mobile and fixed tibial component, respectively. In 10° external rotation, minimal principal strain decreased to 421 ± 233m;e; for the mobile bearing, but increased to 632 ± 293m;e; for the fixed bearing. These differences between mobile and fixed bearing scenarios were highly statistically significant.

For this in-vitro study under exact controlled loading conditions the mobile bearing design induced less strain in the proximal tibia than the fixed bearing tibial component. The difference in strain levels may be of importance for bone remodeling and osseointegration.