title: Analysis of stem tip pain in revision total knee arthroplasty.
abstract: Stem tip pain following revision total knee arthroplasty is a significant cause of patient dissatisfaction, which in the presence of an aseptic well-fixed component has no widely accepted surgical solution. A definitive cause of stem tip pain remains elusive, however it has been suggested that high stress concentrations within the region of the stem tip may play a role. This paper reports a finite element study of a novel clinical technique where a plate is attached to the tibia within the region of the stem tip to reduce stem tip pain. The results demonstrate that the plate reduces stress concentrations in the bone at the stem tip of the implant. The magnitude of stress reduction is dependent upon plate location, material and attachment method.
authors.affiliation: Division of Mechanical, Medical and Aerospace Engineering, University of Surrey, Guildford, UK.
authors.forename: Christine I
authors.initials: CI
authors.lastname: Kimpton
authors.forename: Andrew David
authors.initials: AD
authors.lastname: Crocombe
authors.forename: William Neil
authors.initials: WN
authors.lastname: Bradley
authors.forename: Brigstocke
authors.initials: B
authors.lastname: Gavin Huw Owen
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D001860:Bone Plates; D020342:Finite Element Analysis; D006801:Humans; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control*; D012086:Reoperation / Q000009:adverse effects