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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_5 | Pages 65 - 65
1 Apr 2019
DesJardins J Stokes M Pietrykowski L Gambon T Greene B Bales C
Full Access

Introduction

There are over ½ million total knee replacement (TKR) procedures performed each year in the United States and is projected to increase to over 3.48 million by 2030. Concurrent with the increase in TKR procedures is a trend of younger patients receiving knee implants (under the age of 65). These younger patients are known to have a 5% lower implant survival rate at 8 years post-op compared to older patients (65+ years), and they are also known to live more active lifestyles that place higher demands on the durability and functional performance of the TKR device. Conventional TKR designs increase articular conformity to increase stability, but these articular constraints decrease patient range of knee motion, often limiting key measures of femoral rollback, A/P motion, and deep knee flexion. Without this articular constraint however, many patients report TKR “instability” during activities such as walking and stair descent, which can significantly impede confidence of movement. Therefore, there is a need for a TKR system that can offer enhanced stability while also maintaining active ranges of motion.

Materials and Methods

A novel knee arthroplasty system has been designed that uses synthetic ligament systems that can be surgically replaced, to provide ligamentous stability and natural motion to increase the functional performance of the implant. A computational anatomical model (AnyBody) was developed that incorporated ligaments into an existing Journey II TKR. Ligaments were modeled and given biomechanical properties from literature. Simulated A/P drawer tests and knee flexion were analyzed for 2,916 possible cruciate ligament location and length combinations to determine the effects on the A/P stability of the TKR. A physical model was then constructed, and the design was verified by performing 110 N A/P drawer tests under 710 N of simulated body weight.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_5 | Pages 65 - 65
1 Apr 2018
DesJardins J Stokes M Pietrykowski L Gambon T Greene B Bales C
Full Access

Introduction

There are over one-half million total knee replacement (TKR) procedures performed each year in the United States and is projected to increase to over 3.48 million by 2030. Concurrent with the increase in TKR procedures is a trend of younger patients receiving knee implants (under the age of 65). These younger patients are known to have a 5% lower implant survival rate at 8 years post-op compared to older patients (65+ years), and they are also known to live more active lifestyles that place higher demands on the durability and functional performance of the TKR device. Conventional TKR designs increase articular conformity to increase stability, but these articular constraints decrease patient range of knee motion, often limiting key measures of femoral rollback, A/P motion, and deep knee flexion. Without this articular constraint however, many patients report TKR “instability” during activities such as walking and stair descent, which can significantly impede confidence of movement. Therefore there is a need for a TKR system that can offer enhanced stability while also maintaining active ranges of motion.

Materials and Methods

A novel knee arthroplasty system was designed that uses synthetic ligament systems that can be surgically replaced, to provide ligamentous stability and natural motion to increase the functional performance of the implant. Using an anatomical knee model from the AnyBody software, a computational model that incorporated ligaments into an existing Journey II TKR was developed. Using the software ligaments were modeled and given biomechanical properties developed from equations from literature. Simulated A/P drawer tests and knee flexion test were analyzed for 2,916 possible cruciate ligament location and length combinations to determine the effects on the A/P stability of the TKR. A physical model was constructed, and the design was verified by performing 110 N A/P drawer tests under 710 N of simulated body weight.