Imperial College London
Alternate

ProfessorJustinCobb

Faculty of Medicine, Department of Surgery & Cancer

Chair in Orthopaedic Surgery
 
 
 
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Contact

 

+44 (0)20 7594 5534j.cobb Website

 
 
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Assistant

 

Miss Colinette Hazel +44 (0)20 7594 2725

 
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Location

 

c/oSir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stoddart:2022:10.1302/2046-3758.118.BJR-2021-0533.R1,
author = {Stoddart, J and Garner, A and Tuncer, M and Cobb, J and van, Arkel RJ},
doi = {10.1302/2046-3758.118.BJR-2021-0533.R1},
journal = {Bone & Joint Research},
title = {The risk of tibial eminence avulsion fracture with bi-unicondylar  knee arthroplasty - a finite element analysis},
url = {http://dx.doi.org/10.1302/2046-3758.118.BJR-2021-0533.R1},
volume = {11},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Aims: To determine the risk of tibial eminence avulsion intraoperatively for bi-unicondylar knee arthroplasty (Bi-UKA) with consideration to the effect of implant positioning, overstuffing, and sex, compared to the risk for isolated medial UKA (UKA-M) and bi-cruciate retaining total knee arthroplasty (BCR-TKA).Methods: Two experimentally validated finite element models of tibia were implanted. Intraoperative loads were applied through the condyles, ACL, MCL and LCL, and the risk of fracture (ROF) was evaluated in the spine as the ratio of the 95th percentile maximum principal elastic strains over the tensile yield strain of proximal tibial bone.Results: Peak tensile strains occurred on the anterior portion of the medial sagittal cut in all simulations. Lateral translation of the medial implant in Bi-UKA had the largest increase in ROF of any of the implant positions (43%). Overstuffing the joint by 2mm had a much larger effect, resulting in a 6-fold increase in ROF. Bi-UKA had ~10% increased ROF compared to UKA-M for both the male and female models, though the smaller, less dense female model had a 1.5 times greater ROF compared to the male model. Removal of anterior bone akin to BCR-TKA doubled ROF compared to Bi-UKA.Conclusion: Tibial eminence avulsion fracture has a similar risk associated with Bi-UKA to UKA-M. The risk is higher for a smaller and less dense tibiae. To minimise risk, it is most important to avoid overstuffing the joint, followed by correctly positioning the medial implant, taking care not to narrow the bony island anteriorly.
AU  - Stoddart,J
AU  - Garner,A
AU  - Tuncer,M
AU  - Cobb,J
AU  - van,Arkel RJ
DO  - 10.1302/2046-3758.118.BJR-2021-0533.R1
PY  - 2022///
SN  - 2046-3758
TI  - The risk of tibial eminence avulsion fracture with bi-unicondylar  knee arthroplasty - a finite element analysis
T2  - Bone & Joint Research
UR  - http://dx.doi.org/10.1302/2046-3758.118.BJR-2021-0533.R1
UR  - https://online.boneandjoint.org.uk/doi/full/10.1302/2046-3758.118.BJR-2021-0533.R1
UR  - http://hdl.handle.net/10044/1/97708
VL  - 11
ER  -
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