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How exactly can computer simulation predict the kinematics and contact status after TKA Examination in individualized models.pdf

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How exactly can computer simulation predict the kinematics and contact status after TKA Examination in individualized models.pdf

Clinical Biomechanics 39 (2016) 65–70 Contents lists available at ScienceDirect Clinical Biomechanics journal homepage: /locate/clinbiomech How exactly can computer simulation predict the kinematics and contact status after TKA? Examination in individualized models Yoshihisa Tanaka, M.D. a, Shinichiro Nakamura, M.D., Ph.D. a,?, Shinichi Kuriyama, M.D., Ph.D. a, Hiromu Ito, M.D., Ph.D. a, Moritoshi Furu, M.D., Ph.D. a, Richard D. Komistek, Ph.D. b, Shuichi Matsuda, M.D., Ph.D. a a Department of Orthopedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan b Center for Musculoskeletal Research, University of Tennessee, Knoxville, TN, USA article info Article history: Received 18 February 2016 Accepted 19 September 2016 Keywords: Total knee arthroplasty Computer simulation Kinematics Contact area Contact stress abstract Background: It is unknown whether a computer simulation with simple models can estimate individual in vivo knee kinematics, although some complex models have predicted the knee kinematics. The purposes of this study are ?rst, to validate the accuracy of the computer simulation with our developed model during a squatting activity in a weight-bearing deep knee bend and then, to analyze the contact area and the contact stress of the tricondylar implants for individual patients. Methods: We compared the anteroposterior (AP) contact positions of medial and lateral condyles calculated by the computer simulation program with the positions measured from the ?uoroscopic analysis for three implanted knees. Then the contact area and the stress including the third condyle were calculated individually using ?nite element (FE) analysis. Findings: The motion patterns were similar in the simulation program and the ?uoroscopic surveillance. Our developed model could nearly estimate the individual in vivo knee kinematics. The mean and maximum differences of the AP contact positions were 1.0 mm and 2.5 mm, respectively. At 120° of knee ?exion, the contac