{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T19:40:18Z","timestamp":1727811618462},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures. The correct positioning and alignment of the components significantly affects prosthesis survival. Considering the current controversy regarding the target of postoperative alignment of TKA, this study evaluated the tension at tibial component interface using two numerical methods.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The stress of the prosthesis\/bone interface of the proximal tibial component was evaluated using two numerical methods: the finite element method (FEM) and the new meshless method: natural neighbor radial point interpolation method (NNRPIM). The construction of the model was based on Zimmers NexGen LPS-Flex Mobile\u00ae prosthesis and simulated the forces by using a free-body diagram.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Tibiofemoral mechanical axis (TFMA) for which a higher number of nodes are under optimal mechanical tension is between 1\u00b0 valgus 2\u00b0 varus. For values outside the interval, there are regions under the tibial plate at risk of bone absorption. At the extremities of the tibial plate of the prosthesis, both medial and lateral, independent of the alignment, are under a low stress. In all nodes evaluated for all TFMA, the values of the effective stresses were higher in the NNRPIM when compared with the FEM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Through this study, we can corroborate that the optimal postoperative alignment is within the values that are currently considered of 0 \u00b1 3\u00b0 varus. It was verified that the meshless methods obtain smoother and more conservative results, which may make them safer when transposed to the clinical practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/j.pbj.0000000000000208","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T13:09:57Z","timestamp":1680872997000},"update-policy":"http:\/\/dx.doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Total knee arthroplasty coronal alignment and tibial base stress\u2014a new numerical evaluation"],"prefix":"10.1097","volume":"8","author":[{"given":"Jo\u00e3o","family":"Vale","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Centro Hospitalar do Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa V.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Physical and Medicine Rehabilitation, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Barros","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Centro Hospitalar do Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Diniz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Centro Hospitalar do Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Centro Hospitalar do Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Marques","sequence":"additional","affiliation":[{"name":"Institute of Science and Innovation in Mechanical and Industrial Engineering, INEGI, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Belinha","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, School of Engineering, Polytechnic of Porto, ISEP, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ad\u00e9lio","family":"Vila\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Centro Hospitalar do Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,3]]},"reference":[{"key":"R2-20241001","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J Bone Joint Surg Am."},{"key":"R4-20241001","doi-asserted-by":"crossref","first-page":"8046","DOI":"10.1016\/j.actbio.2013.05.005","article-title":"Osteolysis around total knee arthroplasty: a review of pathogenetic mechanisms","volume":"9","author":"Gallo","year":"2013","journal-title":"Acta Biomater."},{"key":"R5-20241001","first-page":"226","article-title":"Densitometric evaluation of periprosthetic bone remodeling","volume":"11","author":"Parchi","year":"2014","journal-title":"Clin Cases Miner Bone Metab."},{"key":"R6-20241001","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2106\/00004623-200302000-00012","article-title":"Factors affecting the durability of primary total knee prostheses","volume":"85-A","author":"Rand","year":"2003","journal-title":"J Bone Joint Surg Am."},{"key":"R7-20241001","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1302\/0301-620X.90B9.20793","article-title":"Alignment in total knee replacement","volume":"90-B","author":"Sikorski","year":"2008","journal-title":"J Bone Joint Surg Br."},{"key":"R8-20241001","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.arth.2013.04.056","article-title":"Why are total knees failing today? 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