Effect of Post-Cam Design for Normal Knee Joint Kinematic, Ligament, and Quadriceps Force in Patient-Specific Posterior-Stabilized Total Knee Arthroplasty by Using Finite Element Analysis

Abstract EN

The purpose of this study is to investigate post-cam design via finite element analysis to evaluate the most normal-like knee mechanics.

We developed five different three-dimensional computational models of customized posterior-stabilized (PS) total knee arthroplasty (TKA) involving identical surfaces with the exception of the post-cam geometry.

They include flat-and-flat, curve-and-curve (concave), curve-and-curve (concave and convex), helical, and asymmetrical post-cam designs.

We compared the kinematics, collateral ligament force, and quadriceps force in the customized PS-TKA with five different post-cam designs and conventional PS-TKA to those of a normal knee under deep-knee-bend conditions.

The results indicated that femoral rollback in curve-and-curve (concave) post-cam design exhibited the most normal-like knee kinematics, although the internal rotation was the closest to that of a normal knee in the helical post-cam design.

The curve-and-curve (concave) post-cam design showed a femoral rollback of 4.4 mm less than the normal knee, and the helical post-cam design showed an internal rotation of 5.6° less than the normal knee.

Lateral collateral ligament and quadriceps forces in curve-and-curve (concave) post-cam design, and medial collateral ligament forces in helical post-cam design were the closest to that of a normal knee.

The curve-and-curve (concave) post-cam design showed 20% greater lateral collateral ligament force than normal knee, and helical post-cam design showed medial collateral ligament force 14% greater than normal knee.

The results revealed the variation in each design that provided the most normal-like biomechanical effect.

The present biomechanical data are expected to provide useful information to improve post-cam design to restore normal-like knee mechanics in customized PS-TKA.