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http://hdl.handle.net/10773/30474
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DC Field | Value | Language |
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dc.contributor.author | Fonseca, F. | pt_PT |
dc.contributor.author | Sousa, A. | pt_PT |
dc.contributor.author | Completo, A. | pt_PT |
dc.date.accessioned | 2021-02-02T17:43:07Z | - |
dc.date.available | 2021-02-02T17:43:07Z | - |
dc.date.issued | 2020-12-01 | - |
dc.identifier.issn | 2197-1153 | pt_PT |
dc.identifier.uri | http://hdl.handle.net/10773/30474 | - |
dc.description.abstract | Purpose Metaphyseal sleeves are an option for patients with severe metaphyseal bony defects requiring TKA revision. Although sleeves are usually used with stems, little is known about the exact contribution/need of the stem for the initial sleeve-bone interface stability, particularly in the femur, if the intramedullary canal is deformed or bowed. It is hypothesised that diaphyseal-stem addition increases the sleeve-femur interface stability and the strain-shielding effect on the metaphyseal femur relatively to the stemless condition. Material and methods Synthetic-femur was used to measure cortex strain behaviour and implant cortex micromotions for three techniques: only femoral-component, stemless-sleeve and stemmed-sleeve. Paired t-tests were performed to evaluate the statistical significance of the difference between mean principal strains and implant-cortex micromotions. Finite-element models were developed to assess the cancellous-bone strain behaviour and sleeve-bone interface micromotions; these models were validated against the measurements. Results Cortex strains are reduced significantly (p<0.05) in 83% of strain gauges on stemmed-sleeve, which compares with 33% in stemless condition. Both techniques presented a cancellous bone strain reduction of 50% at the distal region and an increase of nearly four times at the sleeve proximal region relative to the model only with the femoral component. Both techniques presented sleeve-bone micromotions amplitude below 50-150μm, suitable for bone ingrowth. Conclusions The use of a supplemental diaphyseal-stem potentiates the risk of cortex bone resorption compared with the stemless-sleeve condition; however, the stem is not vital for increasing the initial sleeve-bone stability and has a minor effect on the cancellous-bone strain behaviour. Of a purely structural point view, appears that the use of a diaphyseal-femoral-stem with the metaphyseal sleeve is not mandatory in the revision TKA which is particularly relevant in cases where the use of stems is impracticable. | pt_PT |
dc.language.iso | eng | pt_PT |
dc.publisher | SpringerOpen | pt_PT |
dc.relation | POCI-01-0145-FEDER-028424 | pt_PT |
dc.relation | PTDC/EME-SIS/28424/2017 | pt_PT |
dc.rights | openAccess | pt_PT |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | pt_PT |
dc.subject | Experimental strains | pt_PT |
dc.subject | Finite element model | pt_PT |
dc.subject | Metaphyseal sleeve | pt_PT |
dc.subject | Stress-shielding | pt_PT |
dc.subject | Total knee arthroplasty | pt_PT |
dc.subject | Revision | pt_PT |
dc.subject | Metaphyseal bony defects | pt_PT |
dc.title | Femoral revision knee Arthroplasty with Metaphyseal sleeves: the use of a stem is not mandatory of a structural point of view | pt_PT |
dc.type | article | pt_PT |
dc.description.version | published | pt_PT |
dc.peerreviewed | yes | pt_PT |
degois.publication.issue | 1 | pt_PT |
degois.publication.title | Journal of Experimental Orthopaedics | pt_PT |
degois.publication.volume | 7 | pt_PT |
dc.identifier.doi | 10.1186/s40634-020-00242-w | pt_PT |
dc.identifier.essn | 2197-1153 | pt_PT |
Appears in Collections: | TEMA - Artigos DEM - Artigos |
Files in This Item:
File | Description | Size | Format | |
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Author Manuscript - Femoral revision knee Arthroplasty with Metaphyseal sleeves_the use of a stem is not mandatory of a structural point of view.pdf | 1.28 MB | Adobe PDF | View/Open |
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