Proksimal Fibular Osteotomisi ile Kombine Tek Kompartmanlı Diz Artroplastisinin Sonlu Eleman Analizi ile İncelenmesi

Yıl 2020, Cilt: 2 Sayı: 2, 121 - 126, 31.12.2020

Nihat Demirhan Demirkıran , R. Bugra Husemoglu

Öz

Konservatif yöntemlerin yanı sıra, medial gonartroz tedavisi için yüksek tibial osteotomi (HTO), unikondiler diz artroplastisi (UKA) ve total diz artroplastisi (TKA) gibi çeşitli cerrahi tedavi yöntemleri uygulanmaktadır. UKA ve PFO'nun birlikte uygulanması, implant üzerindeki yükü ve ardından implant aşınmasını azaltarak daha uzun implant ömrü sağlayabilir. UKA implantı üzerinde fibulektominin uygulanması implant üzerindeki temas stresini azaltıp azaltmayacağını sonlu elemanlar (FE) modeli üzerinde araştırmayı amaçladık.

Çalışmada kullanılmak üzere UKA implantasyonu ve fibula osteotomisinden kaynaklanan biyomekanik ortamdaki değişiklikleri değerlendirmek için Sonlu Elemanlar modeli geliştirildi. Menisküs, kemik ve implantlar lineer elastik izotropik malzeme olarak modellendi. UKA implantı ile 3B diz eklemi modeli oluşturulup bu model üzerinde PFO uygulanmıştır.

Anatomik olarak femur başına 800N luk dikey yük uygulandı. Fibulektomi yapılmadan önce ve sonra tibial komponent üzerindeki stres değerleri değerlendirildi. Temas stresi, UKA için ortalama (10,2 MPa ± 6,8) ve UKA + Fibulektomi için (9,44 MPa ± 6,5) olarak raporlandı.

PFO ve UKA'nın birlikte uygulanması, Sonlu Elemanlar Modelinde implant üzerindeki temas gerilimlerini azaltmıştır. Gözlemlerimizin bulguları ayrıca UKA'nın etkilenen hasta memnuniyetini, tıbbi etkileri ve implant ömrünü artırabilecek ek bir öneri sunmaktadır.

Anahtar Kelimeler

unikondiler diz artroplastisi, proksimal fibular osteotomi, sonlu eleman analizi

Finite Element Analysis of Unicondylar Knee Arthroplasty Combined with Proximal Fibular Osteotomy

Öz

Besides conservative methods, various surgical treatment modalities including high tibial osteotomy (HTO), unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) have been applied for the treatment of medial gonarthrosis. Combined application of UKA and PFO may enable longer implant survival by reducing the load over the implant and subsequent implant wear. We aimed to investigate on a finite element (FE) model, whether integrating a fibulectomy would reduce the contact stresses on the UKA implant. Finite Elements model developed to evaluate changes in the biomechanical environment resulting from UKA implantation and fibula osteotomy for use in the study. Menisci, bone and implants modeled as linear elastic isotropic material. We developed a 3D knee joint model with UKA implant and performed PFO on this model. A vertical load of 800N was applied anatomically to the femoral head. Stress on the tibial component was assessed before and after fibulectomy was performed. The contact stress was evaluated for UKA the mean stress (10,2 MPa ± 6,8) and for UKA + Fibulectomy (9,44 MPa ± 6,5). Combined application of PFO and UKA reduced contact stresses over the implant on a Finite Element Model. The findings of our observe additionally offer which might also additionally enhance the affected patient satisfaction, medical effects and implant survivorship of UKA.

Anahtar Kelimeler

unicondylar knee arthroplasty, proximal fibular osteotomy, finite element analysis

Kaynakça

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