Sensitivity of total knee replacement wear to variability in motion and load input: A parametric finite element analysis study.
Sensitivity of total knee replacement wear to variability in motion and load input: A parametric finite element analysis study.
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DOI：
10.1002/jor.24755
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发表时间：
2020-07
影响因子：
2.8
通讯作者：
Lundberg, Hannah J.
中科院分区：
文献类型：
--
作者：
Mell, Steven P.;Wimmer, Markus A.;Lundberg, Hannah J.
聚乙烯磨损仍然是全膝关节置换术(TKRs)长期失败的原因之一。材料的进步提高了聚乙烯的磨损率，因此进一步降低磨损率需要更好地了解导致磨损的患者特定因素。患者步态的可变性很大，可能会导致标准测试方法无法预测的磨损率的显着差异。在硅胶研究中，研究步态变化对TKR聚乙烯磨损的影响。试验中使用的载荷和运动曲线中的9个特征峰值与基线(−-14243-3：2014)相比变化了75%和125%，以生成310个独特的波形。使用有限元TKR磨损模型计算了100万次循环的磨损。根据结果，使用多元线性回归建立了替代模型，并用于预测运动和力峰在a)±5%和b)±25%范围内的磨损变化，a)±5%是ISO的最大允许输入容差，b)±25%更能反映患者步态的内部可变性。磨损范围在±5%的容差范围内为0.65mm3/百万次循环，在±25%的变异性内为3.24mm3/百万次循环，与患者体内观察到的分散度更符合。虽然在TKR体积磨损中没有一个运动学或动力学峰值主导磨损率的变异性，但弯曲/伸展峰内的变异性是磨损率变异性的最大贡献因素。不同波形的峰之间的相互作用也很重要。这项研究，以及未来结合患者特定数据的研究，可能有助于解释患者特定步态因素与佩戴率之间的联系。
Polyethylene wear remains a contributor to long term failure in total knee replacements (TKRs). Advances in materials have improved polyethylene wear rates, therefore further wear reductions require a better understanding of patient specific factors that lead to wear. Variability of gait within patients is considerable and could lead to significant variability in wear rates that cannot be predicted by standard testing methods. An in-silico study was performed to investigate the influence of gait variability on TKR polyethylene wear. Nine characteristic peaks within the load and motion profiles used for TKR wear testing were varied 75%−125% from baseline (ISO-14243–3:2014) to generate 310 unique waveforms. Wear was calculated for 1-million cycles using a finite element TKR wear model. From the results, a surrogate model was developed using multiple linear regression, and used to predict how wear changes due to dispersion of motion and force peaks within a) ±5%, the maximum allowable input tolerance of ISO, and b) ±25%, more reflective of patient gait inter-variability. The range of wear within the ±5% tolerance was 0.65 mm3/million cycles and was 3.24 mm3/million cycles within the ±25% variability more in line with the dispersion observed within patients. Although no one kinematic or kinetic peak dominated variability in TKR volumetric wear, variability within flexion/extension peaks were the largest contributor to wear rate variability. Interaction between the peaks of different waveforms was also important. This study, and future studies incorporating patient specific data, could help to explain the connection between patient specific gait factors and wear rates.
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影响因子：
2.4
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