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Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study.

Publication ,  Journal Article
Johnson, JE; Clarke, GA; de Cesar Netto, C; Anderson, DD
Published in: J Orthop Res
July 2024

The success of uncemented total ankle replacement (TAR) is linked to initial stability because bony ingrowth depends upon limited early micromotion. Tibial implant design fixation features resist micromotion aided by bony sidewall retention and interference fit. Our goal was to investigate factors influencing implant-bone micromotion in TAR. Two TAR tibial components were virtually inserted into CT-derived computer models of two distal tibias from patients with end-stage ankle arthritis. Density-based inhomogeneous material assignment was used to model bone compaction during press-fit. Finite element analysis (FEA) was used to simulate three fixation cases: (1) no sidewalls + line-to-line fit, (2) sidewalls + line-to-line fit, and (3) sidewalls + 50, 100, or 200 µm interference fit. Kinetic profiles from the stance phase of gait were simulated and micromotions computed from FEA output. Without sidewalls or interference fit, micromotions were largest in early and late stance, with largest micromotions (averaging ~150-250 µm) observed near heel strike. Micromotions decreased 39%-62% when sidewalls were retained. When interference fit was also modeled, micromotions decreased another 37%-61% to ~10 µm. Micromotion differences between patients persisted with sidewall retention but largely disappeared with interference fit. This study presents new insights into the effects of TAR fixation features on implant-bone micromotion. Stability appeared to be influenced by surrounding bone quality, but this influence was greatly diminished when interference fit was introduced. More complete understanding of TAR implant features and performance is needed, but our results show the importance of bone quality and interference fit in the stability of uncemented TAR.

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Published In

J Orthop Res

DOI

EISSN

1554-527X

Publication Date

July 2024

Volume

42

Issue

7

Start / End Page

1536 / 1544

Location

United States

Related Subject Headings

  • Tibia
  • Prosthesis Design
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Prosthesis
  • Humans
  • Finite Element Analysis
  • Female
  • Arthroplasty, Replacement, Ankle
 

Citation

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Johnson, J. E., Clarke, G. A., de Cesar Netto, C., & Anderson, D. D. (2024). Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study. J Orthop Res, 42(7), 1536–1544. https://doi.org/10.1002/jor.25796
Johnson, Joshua E., Gabriel A. Clarke, Cesar de Cesar Netto, and Donald D. Anderson. “Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study.J Orthop Res 42, no. 7 (July 2024): 1536–44. https://doi.org/10.1002/jor.25796.
Johnson JE, Clarke GA, de Cesar Netto C, Anderson DD. Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study. J Orthop Res. 2024 Jul;42(7):1536–44.
Johnson, Joshua E., et al. “Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study.J Orthop Res, vol. 42, no. 7, July 2024, pp. 1536–44. Pubmed, doi:10.1002/jor.25796.
Johnson JE, Clarke GA, de Cesar Netto C, Anderson DD. Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study. J Orthop Res. 2024 Jul;42(7):1536–1544.
Journal cover image

Published In

J Orthop Res

DOI

EISSN

1554-527X

Publication Date

July 2024

Volume

42

Issue

7

Start / End Page

1536 / 1544

Location

United States

Related Subject Headings

  • Tibia
  • Prosthesis Design
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Prosthesis
  • Humans
  • Finite Element Analysis
  • Female
  • Arthroplasty, Replacement, Ankle