Application value of finite element analysis on unicompartmental knee arthroplasty for medial knee compartmental osteoarthritis

Zhang Zizheng; Luo Wang; Liu Changlu

doi:10.12307/2026.652

Abstract：BACKGROUND:Unicompartmental knee arthroplasty is a minimally invasive surgery for end-stage medial knee osteoarthritis and is increasingly used in the field of joint surgery.As an advanced biomechanical research method,finite element analysis can simulate the real human body,reveal the biomechanical characteristics of the knee joint,and provide strong support for optimizing surgical plans and developing new implant materials. OBJECTIVE:To review the advancements of finite element analysis in unicompartmental knee arthroplasty for medial compartment osteoarthritis and forecast future trends. METHODS:The first author searched the PubMed and CNKI for literature published from the inception of the database to December 2024,using"finite element analysis,medial compartment osteoarthritis of the knee,unicompartmental knee arthroplasty,prosthesis alignment,joint line,prosthesis design,fracture risk factors"as English search terms;"finite element analysis,knee joint,unicompartmental knee arthroplasty,prosthesis alignment,joint line,prosthesis design,fracture risk factors"as Chinese search terms.Finally,53 articles were included for analysis. RESULTS AND CONCLUSION:(1)Tibial prosthesis arrangement:Fixed platform unicompartmental knee arthroplasty recommends a coronal surface of 0°,posterior inclination of 5°-7°,while for movable platform unicompartmental knee arthroplasty,it suggests a coronal surface of varus 4° to valgus 4°,posterior inclination of 3°-7°,and axial rotation of 0° to external rotation 3°.(2)Femoral prosthesis alignment:Fixed-bearing unicompartmental knee arthroplasty:Coronal alignment at 0°(neutral)distal femoral center;sagittal alignment 9°-12° posterior tilt.Mobile-bearing unicompartmental knee arthroplasty:Coronal alignment 4° varus to 4° valgus;axial rotation 0°(neutral)to 6° internal rotation.(3)The joint line should maintain the original height.(4)Prosthesis design:Fixed platform unicompartmental knee arthroplasty should use a liner with a flat or anatomical simulation design,while movable platform unicompartmental knee arthroplasty benefits from an anatomical simulation pad or one with increased anatomical consistency.Moreover,the tibial tray design preferably features two straight columns with fin bone or small keel combinations,with a recommended tibial prosthesis column length of 33 mm.