Changhyun Baek

Measuring the effect of femoral malrotation on knee joint biomechanics for total knee arthroplasty using computational simulation

Objectives Malrotation of the femoral component can result in post-operative complications in total knee arthroplasty (TKA), including patellar maltracking. Therefore, we used computational simulation to investigate the influence of femoral malrotation on contact stresses on the polyethylene (PE) insert and on the patellar button as well as on the forces on the collateral ligaments. Materials and Methods Validated finite element (FE) models, for internal and external malrotations from 0° to 10° with regard to the neutral position, were developed to evaluate the effect of malrotation on the femoral component in TKA. Femoral malrotation in TKA on the knee joint was simulated in walking stance-phase gait and squat loading conditions. Results Contact stress on the medial side of the PE insert increased with internal femoral malrotation and decreased with external femoral malrotation in both stance-phase gait and squat loading conditions. There was an opposite trend in the lateral side of the PE insert case. Contact stress on the patellar button increased with internal femoral malrotation and decreased with external femoral malrotation in both stance-phase gait and squat loading conditions. In particular, contact stress on the patellar button increased by 98% with internal malrotation of 10° in the squat loading condition. The force on the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) increased with internal and external femoral malrotations, respectively. Conclusions These findings provide support for orthopaedic surgeons to determine a more accurate femoral component alignment in order to reduce post-operative PE problems. Cite this article: K-T. Kang, Y-G. Koh, J. Son, O-R. Kwon, C. Baek, S. H. Jung, K. K. Park. Measuring the effect of femoral malrotation on knee joint biomechanics for total knee arthroplasty using computational simulation. Bone Joint Res 2016;5:552–559. DOI: 10.1302/2046-3758.511.BJR-2016-0107.R1.

Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis.

Unicompartmental knee arthroplasty (UKA) is an effective surgical technique for pain relief and functional restoration in patients with localized osteoarthritis of the knee joint. However, the role of the joint line in UKA, especially its biomechanical effect, has not been previously investigated. This study numerically evaluates the effects of the joint line on the contact stresses in polyethylene (PE) inserts, articular cartilage, and lateral meniscus using the finite element (FE) analysis. The FE model for joint line was modeled as the orthogonal projection line from the medial tibial plateau to the anatomical axis. The joint line was varied from −6 to +6 mm in 2 mm intervals, and the seven FE models were analyzed and compared under ISO gait loading conditions. The contact stresses in the PE insert, articular cartilage, and lateral meniscus matched those of the reference joint line (0 mm) in the ±2 and ±4 mm joint line cases but significantly differed from the reference in the ±6 mm joint line cases. On the +6 mm joint line, the contact stress was greater on the PE insert than on the articular cartilage, whereas the reverse occurred on the −6 mm joint line. This study confirms the post‐operative significance of joint line preservation in UKA implantation surgery.

Wear predictions for UHMWPE material with various surface properties used on the femoral component in total knee arthroplasty: a computational simulation study

The wear of ultrahigh-molecular weight polyethylene (UHMWPE) tibial inserts in total knee arthroplasty (TKA) remains a major limitation that hinders the longevity of clinically successful devices. Surface properties significantly affect the overall performance of TKA, and surface modification with mechanically and chemically stable materials is an effective method for overcoming the wear of TKA. However, wear tests are not cost-efficient or time-efficient; thus, the effects of geometric, loading, and alignment perturbations are often evaluated via parametric studies. Computational wear prediction using a finite element (FE) model followed by validation through comparison with experimental data is effective for assessing new prosthetic designs or surface change methods prior to functional testing and surgical implementation. The aim of this study was to evaluate the weight loss, wear depth, and kinematics for different surface properties, including nanostructured diamond (NSD), diamond-like carbon (DLC), titanium-nitride (TiN), and oxidized zirconium (OxZr) on femoral components in TKA using FE analysis under gait-cycle loading conditions. Weight loss and wear depth were lowest with OxZr followed by TiN, NSD, and DLC. However, the DLC femoral component did not show any improvement in wear rate compared to an uncoated cobalt–chromium (Co–Cr) femoral component. Not all surface changes applied in this study did lead to improvement in wear performance. However, this study demonstrates the potential of OxZr and TiN for reducing UHMWPE wear and offers new insights into the effects of wear on TKA.Graphical Abstract

Morphometry of femoral rotation for total knee prosthesis according to gender in a Korean population using three-dimensional magnetic resonance imaging

BACKGROUND We aimed to evaluate differences in femoral arthometric data for 700 osteoarthritic knees (587 females and 113 males) with respect to gender in a Korean population. METHODS We identified and measured the mediolateral (ML) and anteroposterior (AP) lengths, femoral aspect ratio (ML/AP), surgical epicondylar axis (SEA), and Whitesides line (WL). In addition, the anterior, posterior, and distal bone resections of the implanted femurs were evaluated using SEA and WL as references using a three-dimensional analysis method. RESULTS ML and AP lengths significantly differed according to gender. ML dimension and aspect ratio were greater in males than in females for a given AP dimension in the femur. No statistically significant differences in femoral rotation with SEA as a reference were observed between male and female knees; however, a significant difference was shown using WL as a reference and both affected the amount of bone resection irrespective of gender. CONCLUSION This study provides important guidelines for gender-specific femoral prosthesis design with different ML and AP aspect ratios and femoral rotation based on SEA and WL for Korean populations.

Femoral component alignment in unicompartmental knee arthroplasty leads to biomechanical change in contact stress and collateral ligament force in knee joint

BackgroundIn recent years, the popularity of unicompartmental knee arthroplasty (UKA) has increased. However, the effect of femoral component positioning in UKA continues to invite a considerable debate. The purpose of this study involved assessing the biomechanical effect of mal-alignment in femoral components in UKA under dynamic loading conditions using a computational simulation.MethodsA validated finite element model was used to evaluate contact stresses in polyethylene (PE) inserts and lateral compartment and force on collateral ligament in the femoral component ranging from 9° of varus to 9° of valgus.ResultsThe results indicated that contact stress on the PE insert increased with increases in the valgus femoral alignment when compared to the neutral position while contact stress on the lateral compartment increased with increases in the varus femoral alignment. The forces on medial and lateral collateral ligaments increased with increases in valgus femoral alignments when compared to the neutral position. However, there was no change in popliteofibular and anterior lateral ligaments with respect to the malpositioning of femoral component.ConclusionThe results of the study confirm the importance of conservation in post-operative accuracy of the femoral component since the valgus and varus femoral malalignments affect the collateral ligament and lateral compartment, respectively. Our results suggest that surgeons should avoid valgus malalignment in the femoral component and especially malalignment exceeding 9°, which may induce higher medial collateral ligament forces.

Effects of measurement methods for tibial rotation axis on the morphometry in Korean populations by gender

BACKGROUND There have been arguments for methodology in tibial rotation axis measurement, which accordingly determines the morphometry of the proximal tibia in total knee arthroplasty. The morphometry of the proximal tibia for the Korean population is determined by gender, based on the anatomical tibial axis and reliable rotational orientation in knee replacements, to evaluate the size suitability of the currently available prostheses in Korea. METHODS This study reconstructed the MRI images in three-dimensions for identification and measurement of the mediolateral (ML) and anteroposterior (AP) lengths of the proximal tibia and the tibial aspect ratio (ML/AP) using proximal tibial anthropometric data for 700 osteoarthritic knees (587 females and 113 males). The ML and AP lengths were measured using tibial rotation axis techniques based on the medial one-third tibial tubercle and Cobbs method. RESULTS Significant differences (P<0.05) in ML, medial anteroposterior (MAP), lateral anteroposterior (LAP) lengths, and aspect ratio (ML/LAP) were observed for males and females with respect to different measurement techniques for the tibial rotation axis. However, the measured aspect ratio (ML/MAP) of tibiae for the Korean population did not show significance. The measured aspect ratio (ML/AP) ratio of tibiae for the Korean population was higher than that of currently available tibial components. CONCLUSIONS Results from this study can guide development of gender-specific tibial prosthesis designs with different ML and AP aspect ratios based on the tibial anatomical rotation axis for the Korean population.

Analytical Study on the Heating Performance Improvement of a CO 2 Heat Pump Using Vapor Injection

ABSTRACT: In this study, a simulation model for a CO 2 heat pump using vapor injection was developed and validated. It was used to predict the improvement of the heating performance of the CO 2 heat pump at various operating conditions. The simulation results showed consistent results with the measured data. The heating performances of the vapor injection and non-injection heat pumps were compared by varying the outdoor temperature and compressor frequency. The heating capacity of the vapor injection heat pump was 40% higher than that of the non-injection heat pump at the outdoor temperature of -8℃. The performance of the vapor injection heat pump was consistently higher than that of the non-injection heat pump even when the compressor frequency was reduced to 35 Hz at the outdoor temperature of -3℃.Keywords: CO 2 heat pump(이산화탄소 열펌프), Vapor injection(가스인젝션), Simulation(시뮬레이션) †Corresponding author Tel.: +82-2-3290-3366; fax: +82-2-921-5439 E-mail address: yongckim@korea.ac.kr 기 호 설 명

Experimental Study on the Performance of a CO 2 Heat Pump Water Heater under Various Operating Conditions

In this study, the steady state performance of a heat pump water heater was measured with a variation of operating conditions such as refrigerant charge amount, compressor frequency, EEV opening, and water mass flow rate. Transient state performance tests were also conducted to investigate major system effects associated with the interaction between the heat pump water heater and the water tank. Optimum refrigerant charge amount for the system was 1600 g. At compressor frequencies of 50 Hz and 60 Hz, water mass flow rates of 95 kg/h and 105 kg/h, and EEV opening of 8% and 16%, the water heating temperatures were and and COPs were 3.0 and 2.8, respectively. In the transient condition, the instantaneous COP decreased with an increase in the inlet water temperature.

Cooling and Heating Performances of a CO2 Heat Pump with the Variations of Operating Conditions

Abstract Since operating conditions are significantly different for heating and cooling mode operations in a CO 2 heat pump system, it is difficult to optimize the performance of the CO 2 cycle. In addition, the performance of a CO 2 heat pump is very sensitive to outdoor temperature and gascooler pressure. In this study, the cooling and heating performances of a variable speed CO 2 heat pump with a twin-rotary compressor were measured and analyzed with the variations of EEV opening and compressor frequency. As a result, the cooling and heating COPs were 2.3 and 3.0, respectively, when the EEV opening was 22%. When the optimal EEV openings for heating and cooling were 28% and 16%, the cooling and heating COPs increased by 3.3% and 3.9%, respectively, over the COPs at the EEV opening of 22%. Beside, the heating performance was more sensitive to EEV opening than the cooling performance. As the compressor speed decreased by 5 Hz, the cooling COP increased by 2%, while the heating COP decreased by 8%.