| Effect of implantation accuracy on ankle contact mechanics with a metallic focal resurfacing implant. | |
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MedLine Citation:
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PMID: 20516325 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Donald D Anderson; Yuki Tochigi; M James Rudert; Tanawat Vaseenon; Thomas D Brown; Annunziato Amendola |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of bone and joint surgery. American volume Volume: 92 ISSN: 1535-1386 ISO Abbreviation: J Bone Joint Surg Am Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-02 Completed Date: 2010-07-08 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 1490-500 Citation Subset: AIM; IM |
Affiliation:
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Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100, USA. don-anderson@uiowa.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Ankle Injuries / physiopathology, surgery* Ankle Joint / physiopathology, surgery* Arthroplasty, Replacement / methods Biomechanics Cadaver Female Humans Joint Prosthesis Male Stress, Mechanical |
| Grant Support | |
ID/Acronym/Agency:
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P50 AR055533/AR/NIAMS NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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