The articulation of the femoral and tibial component contact surface is influenced by the alignment of these components. Malalignment of the total knee is perceived to increase the contact pressure and reduces the life of the polyethylene component. In this paper the contact pressure obtained from a experimental results  are used as the loading condition for a normal TKA alignment. In the case of a malalignment, we assumed that the loads at the interface do not change and the malalignment is to the femur component rotation. The results show that the pressure distribution is higher in the malaligned fit, which implies a reduced lifetime for the TKA. In the analysis, the experimental loads derived from cadaver knee testing are increased by a scale factor of 5, 10, 20, 50 to predict a more realistic loading condition of the knee. The effect of malrotation on the pressure distribution under these condition shows that the percentage change in the pressure distribution is slightly larger than that from the experimental loads.
Effect of Malalignment and Friction on Contact Pressure in the Polyethylene Component in the Total Knee Replacement
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Chandran, N, Amirouche, F, Goldstein, W, & Barmada, R. "Effect of Malalignment and Friction on Contact Pressure in the Polyethylene Component in the Total Knee Replacement." Proceedings of the ASME 2002 International Mechanical Engineering Congress and Exposition. Advances in Bioengineering. New Orleans, Louisiana, USA. November 17–22, 2002. pp. 423-424. ASME. https://doi.org/10.1115/IMECE2002-32615
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