2023, Vol. 27 ›› Issue (31): 5058-5063

Application of finite element analysis in artificial knee arthroplasty

Li Haoran1, Huang Jian2   

Abstract: BACKGROUND: Artificial knee arthroplasty is widely used in the field of joint surgery as the most effective treatment for various end-stage joint diseases such as knee osteoarthritis and rheumatoid arthritis. Finite element analysis is a biomechanical research method developed gradually with the continuous progress of computer technology, which has a strong modeling function and three-dimensional simulation characteristics. At present, finite element analysis has been widely used in orthopedic biomechanical studies.  
OBJECTIVE: To review the current status and progress of finite element analysis in various types of total knee arthroplasty.
METHODS: Articles related to finite element analysis and artificial knee arthroplasty published from inception to August 2022 were searched on PubMed, CNKI and WanFang databases by computer. English search terms were “finite element analysis, TKA, UKA, revision total knee arthroplasty, knee osteoarthritis, knee joint, femoral component, tibia component”. Chinese search terms were “finite element analysis, total knee arthroplasty, unicompartmental knee arthroplasty, knee revision, knee, femoral prosthesis, tibial prosthesis”. A total of 53 articles were finally included for review.  
RESULTS AND CONCLUSION: (1) In total knee arthroplasty, the mobile bearing reduces the tibiofemoral joint contact surface stress compared with the fixed bearing, thereby reducing the wear of the polyethylene bearing. Compared with mechanical alignment, total knee arthroplasty with kinematic alignment reduces the maximum stress and maximum strain value of femoral prosthesis and polyethylene insert of the artificial joint, and generates lower stress, thus reducing the wear of joint contact surface and prolonging the life of the prosthesis. (2) In unicompartmental knee arthroplasty, the femoral and tibial prostheses of the mobile platform have better conformity and can reduce prosthesis wear; while the fixed platform prosthesis in unicompartmental knee arthroplasty should avoid local stress concentration caused by overconformity and lead to accelerated prosthesis wear. (3) In revision total knee arthroplasty, the design length of the stem extension should maintain the best balance between preserving bone quality and reducing periprosthetic stress after implantation. Press-fit stems showed higher micromotion compared to cemented stems. (4) Compared with traditional mechanical research, finite element analysis can carry out relatively accurate simulations and make up for the shortcomings of traditional mechanics in knee joint research, so it has a high application value in the medical field.

Key words: finite element analysis, total knee arthroplasty, unicompartmental knee arthroplasty, revision total knee arthroplasty, knee joint, femoral prosthesis, tibial prosthesis