Biomechanical behavior of a cemented ceramic knee replacement under worst case scenarios

In connection with technological advances in the manufacturing of medical ceramics, a newly developed ceramic femoral component was introduced in total knee arthroplasty (TKA). The motivation to consider ceramics in TKA is based on the allergological and tribological benefits as proven in total hip arthroplasty. Owing to the brittleness and reduced fracture toughness of ceramic materials, the biomechanical performance has to be examined intensely. Apart from standard testing, we calculated the implant performance under different worst case scenarios including malposition, bone defects and stumbling. A finite-element-model was developed to calculate the implant performance in situ. The worst case conditions revealed principal stresses 12.6 times higher during stumbling than during normal gait. Nevertheless, none of the calculated principal stress amounts were above the critical strength of the ceramic material used. The analysis of malposition showed the necessity of exact alignment of the implant components.

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