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Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study
Journal article   Open access   Peer reviewed

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

Joshua E Johnson, Gabriel A Clarke, Cesar de Cesar Netto and Donald D Anderson
Journal of orthopaedic research, Vol.42(7), pp.1536-1544
07/2024
DOI: 10.1002/jor.25796
PMID: 38327023
url
https://doi.org/10.1002/jor.25796View
Published (Version of record) Open Access

Abstract

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.
Finite Element Analysis micromotion primary fixation interference fit total ankle replacement UIOWA OA Agreement

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