{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T18:37:41Z","timestamp":1783795061911,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2017M3A9E9073545"],"award-info":[{"award-number":["2017M3A9E9073545"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study was performed to determine whether metal block augmentation is suitable for large uncontained bone defect via evaluations of differences in biomechanical characteristics among the configurations of metal block augmentations for medium or large uncontained bone defects in revision total knee arthroplasty (TKA). Three-dimensional finite element (FE) models of the proximal tibia with revision TKA were developed and analyzed considering the configurations of the metal block augmentations for medium and large uncontained bone defects. To identify differences in biomechanical characteristics according to the configurations of metal block augmentations, the stress transfer, strain distribution, and peak von Mises stresses (PVMSs) were assessed. Large and medium uncontained bone defects had similar ranges of strain below the critical bone-damage strain for the metal block augmentations, but the strain distribution characteristics differed in response to the metal block-augmentation configurations. PVMSs exceeding the yield strength of the bone cement for the single metal block-augmentation configurations were, on average, 1.4 times higher than those for double metal block-augmentation configurations for both medium and large uncontained bone defects. These findings suggest that metal block augmentation may be suitable for large uncontained bone defects (\u226420 mm), compared with the results obtained for metal block augmentation used in medium uncontained bone defects (\u226410 mm). If possible, double metal block augmentation is recommended for both medium and large uncontained bone defects rather than single metal block augmentation. It is also recommended that the metal block augmentation should be customized to meet the contact characteristics with the cortical bone, thereby ensuring better stress transfer and reducing the risk of the bone resorption due to stress shielding and bone-cement failure.<\/jats:p>","DOI":"10.3390\/jcm8030384","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T12:12:25Z","timestamp":1552997545000},"page":"384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Suitability of Metal Block Augmentation for Large Uncontained Bone Defect in Revision Total Knee Arthroplasty (TKA)"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5536-8804","authenticated-orcid":false,"given":"Kwan Su","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea"},{"name":"Department of Research &amp; Development, Medical Device Development Center, OSONG Medical Innovation Foundation, Cheongju 28160, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinh Ngoc","family":"Tien","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Chul","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, College of medicine, Seoul National University, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwon-Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-5977","authenticated-orcid":false,"given":"Bongju","family":"Kim","sequence":"additional","affiliation":[{"name":"Dental Life Science Research Institute, Clinical Translational Research Center for Dental Science, Seoul National University, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3752-7079","authenticated-orcid":false,"given":"Dohyung","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea"},{"name":"Department of Research &amp; Development, RNX Co., Ltd, Seoul 05006, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1001\/2012.jama.11153","article-title":"Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991\u20132010","volume":"308","author":"Cram","year":"2012","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.arth.2013.04.051","article-title":"Why are total knee arthroplasties being revised?","volume":"28","author":"Dalury","year":"2013","journal-title":"J. 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