ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1634172
Optimising Tibial Extension Stem Selection in Total Knee Arthroplasty: The Role of Digital Modelling
Provisionally accepted
- 1UPR3346 Institut P' Recherche et Ingénierie en Matériaux, Mécanique et Energétique (Pprime), Poitiers, France
- 2Laboratoire de Biomecanique et Mecanique des Chocs, Bron, France
- 3Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- 4Clinique Porte Océane, Les Sables d'Olonne, France
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Abstract Introduction This study explores the biomechanical impact of tibial extension stems in total knee arthroplasty (TKA) using finite element (FE) digital modelling. The objective is to enhance stem selection by assessing stress and strain distribution in periprosthetic bone under varied loading scenarios. Methods Six patient-specific FE models were created, each with different stem dimensions, to evaluate how stem geometry affects implant stability and fracture risk. This is a provisional file, not the final typeset article Results Extension stems reduce strain under the tibial baseplate but increase stress and fracture risk in the surrounding bone, particularly at the stem tip. Larger stem diameters were linked to higher fracture risks due to increased press-fit contact. Conclusions These findings are consistent with previous research emphasizing the importance of stem design in achieving a balance between implant stability and bone preservation. The study offers a biomechanical foundation for surgical planning, potentially improving TKA durability and functional outcomes. Incorporating these insights into clinical practice may enhance the longevity of knee replacements and overall patient quality of life.
Keywords: Total knee arthroplasty, Extension stem, Biomechanics, Finite Element Analysis, Patient specific
Received: 23 May 2025; Accepted: 16 Sep 2025.
Copyright: © 2025 Zot, Germaneau, Gardegaront, Vendeuvre and Severyns. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: François Zot, francois.zot@univ-poitiers.fr
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