Effect of Implantation Accuracy on Ankle Contact Mechanics with a Metallic Focal Resurfacing Implant

Donald D ANDERSON; Yuki TOCHIGI; M. James RUDERT; Tanawat VASEENON; Thomas D BROWN; Annunziato AMENDOLA

doi:10.2106/JBJS.I.00431

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Effect of Implantation Accuracy on Ankle Contact Mechanics with a Metallic Focal Resurfacing Implant

Journal article

Open access

Peer reviewed

Effect of Implantation Accuracy on Ankle Contact Mechanics with a Metallic Focal Resurfacing Implant

Donald D ANDERSON, Yuki TOCHIGI, M. James RUDERT, Tanawat VASEENON, Thomas D BROWN and Annunziato AMENDOLA

Journal of bone and joint surgery. American volume, Vol.92A(6), pp.1490-1500

2010

DOI: 10.2106/JBJS.I.00431

PMCID: PMC2874671

PMID: 20516325

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Abstract

Background: Talar osteochondral defects can lead to joint degeneration. Focal resurfacing with a metallic implant has shown promise in other joints. We studied the effect of implantation accuracy on ankle contact mechanics after focal resurfacing of a defect in the talar dome. Methods: Static loading of seven cadaver ankles was performed before and after creation of a 15-mm-diameter osteochondral defect on the talar dome, and joint contact stresses were measured. The defect was then resurfaced with a metallic implant, with use of a custom implant-bone interface fixture that allowed fine control (in 0.25-mm steps) of implantation height. Stress measurements were repeated at heights of -0.5 to +0.5 mm relative to an as-implanted reference. Finite element analysis was used to determine the effect of implant height, post axis rotation, and valgus/varus tilt over a motion duty cycle. Results: With the untreated defect, there was a 20% reduction in contact area and a 40% increase in peak contact stress, as well as a shift in the location of the most highly loaded region, as compared with the values in the intact condition. Resurfacing led to recovery of 90% of the contact area that had been measured in the intact specimen, but the peak contact stresses remained elevated. With the implant 0.25 mm proud, peak contact stress was 220% of that in the intact specimen. The results of the finite element analyses agreed closely with those of the experiments and additionally showed substantial variations in defect influences on contact stresses across the motion arc. Talar internal/external rotations also differed for the unfilled defect. Focal implant resurfacing substantially restored kinematics but did not restore the stresses to the levels in the intact specimens. Conclusions: Focal resurfacing with a metallic implant appears to have the potential to restore normal joint mechanics in ankles with a large talar osteochondral defect. However, contact stresses were found to be highly sensitive to implant positioning.

Biological and medical sciences

Orthopedic surgery

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Diseases of the osteoarticular system

Details

Title: Subtitle: Effect of Implantation Accuracy on Ankle Contact Mechanics with a Metallic Focal Resurfacing Implant
Creators: Donald D ANDERSON - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
Yuki TOCHIGI - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
M. James RUDERT - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
Tanawat VASEENON - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
Thomas D BROWN - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
Annunziato AMENDOLA - Department of Orthopaedics and Rehabilitation, Orthopaedic Biomechanics Laboratory, The University of Iowa, Iowa City, Iowa, United States
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.92A(6), pp.1490-1500
DOI: 10.2106/JBJS.I.00431
PMID: 20516325
PMCID: PMC2874671
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; Boston, MA
Language: English
Date published: 2010
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040354402771

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