[Objective]To investigate the effect of pillar metal augment used for tibial bone defect in revision knee arthroplasty on the stability of the tibial implant and the bony stress on the tibial plateau.[Methods]Bone defect was created in the medial tibial plateau of a 3D computational model from a composite tibia model,and revision knee arthroplasty was simulated.Cement was used for repairing the tibial bone defect in the traditional revision model(TRM),while pillar metal augment was used for repairing tibial bone defect in the pillar metal augment revision model(PMA).Stem and cone metal augment were used in both revision models.As load was applied to the models,the mi-cromotion at the bone-cement interface and the von Mises stress on the bone of the medial tibial plateau were measured and compared be-tween these two models.[Results]Although there was no significant difference in the micromotion of the cancellous bone-cement interface of the medial tibial plateau between the TRM and PMA[(1.1±0.3)μm vs(1.0±0.4)μm,P=0.365],the TRM proved significantly greater than the PMA in term of the cortical bone-cement interface of the medial tibial plateau[(2.7±1.2)μm vs(2.6±1.2)μm,P=0.032].In addition,the TRM had significantly lower von Mises stress on cancellous bone of the medial tibial plateau than the PMA[(0.2±0.0)MPa vs(0.7±0.1)MPa,P＜0.001],whereas there was no significant difference in von Mises stress on the cortical bone of the tibial plateau between the TRM and the PMA[(4.0±1.3)MPa vs(3.9±1.3)MPa,P=0.071].[Conclusion]The pillar metal augment used for tibial bone defect in revision knee arthro-plasty does improve the stability of the prosthetic component,and increase the stress on cancellous bone of the tibial plateau.
pillar metal augmentsrevision knee arthroplastytibiabone defectfinite element analysis
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