{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:12:05Z","timestamp":1790226725699,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The reconstruction of bone defects in tibial revision knee arthroplasty is challenging. In this study, we evaluated the primary stability of a novel three\u2010dimensional (3D)\u2010printed custom\u2010made metaphyseal cone for Anderson Orthopedic Research Institute (AORI) IIb or III bone defect reconstruction in tibial revision knee arthroplasty using the combination of finite\u2010element analysis and biomechanical experiments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the finite\u2010element analysis, AORI II b and III medial tibial bone defects were designed at varying depths. A novel 3D\u2010printed custom\u2010made metaphyseal cone was designed and used to reconstruct the bone defect with or without a stem in simulated revision total knee arthroplasty (RTKA). A no\u2010stem group and a stem group were established (based on whether a stem was used or not). Von Mises stress and micromotion were calculated with varying depths of bone defects, ranging from 5\u2009mm to 35\u2009mm, and then micromotions at the bone\u2013implant interface were calculated and compared with the critical value of 150\u2009\u03bcm. In the biomechanical experiment, the no\u2010stem group was used, and the same bone defects were made in four synthetic tibias using patient\u2010specific instruments. Micromotions at the bone\u2013implant interface were investigated using a non\u2010contact optical digital image correlation system and compared with the critical value of 150\u2009\u03bcm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When the bone defect was &lt;30\u2009mm, micromotions at the bone\u2013implant interface in the finite\u2010element analysis were all below 150\u2009\u03bcm both in the stem groups and no\u2010stem groups, whereas those in the biomechanical experiment were also below 150\u2009\u03bcm in the no\u2010stem group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 3D\u2010printed custom\u2010made metaphyseal cone in RTKA has excellent primary stability and does not require stems in reconstructing tibial AORI type IIb or III bone defects with a depth of &lt;30\u2009mm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13885","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T09:02:14Z","timestamp":1694768534000},"page":"2937-2946","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Stability of <scp>Three\u2010Dimensional<\/scp> Printed Custom\u2010Made Metaphyseal Cone for Tibial Bone Defects Reconstruction: A Finite Element Analysis and Biomechanical Study"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9163-1945","authenticated-orcid":false,"given":"Xinguang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing 3D Printing Orthopedic Application Engineering Technology Research Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Chen","sequence":"additional","affiliation":[{"name":"Beijing 3D Printing Orthopedic Application Engineering Technology Research Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-481X","authenticated-orcid":false,"given":"Ziyang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0319-873X","authenticated-orcid":false,"given":"Minwei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caimei","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing 3D Printing Orthopedic Application Engineering Technology Research Center  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-3372","authenticated-orcid":false,"given":"Hua","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12425"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B1.36345"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B2.34144"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1697611"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2014.08.017"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1701434"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2255-4971(15)30348-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199910000-00027"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.06.051"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/adem.201400508"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8030384"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2020.104006"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2019.11.021"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2014.948429"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20362"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.2768382"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2008.08.013"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177285"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-020-00242-w"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2583-9"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1730377"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24232"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.94.BJR-2019-0239.R1"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2018.04.010"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20201202-04"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.21823\/2311-2905-2019-25-2-9-18"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03670-6"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13885","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T02:57:55Z","timestamp":1698980275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13885"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/os.13885"],"URL":"https:\/\/doi.org\/10.1111\/os.13885","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]},"assertion":[{"value":"2023-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}