ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1662741
This article is part of the Research TopicRevolutionizing sports science: Biomechanical models, wearable tech, and AIView all 9 articles
Biomechanical and Clinical Evaluation of 3D-Printed Integrated Tibial Prosthesis for Reconstructing AORI Type Ⅲ Tibial Plateau Defects
Provisionally accepted
- 1Dalian Medical University, Dalian, China
- 2Affiliated Zhongshan Hospital of Dalian University, Dalian, China
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Objective: To compare the biomechanical stability and clinical efficacy of 3D-printed integrated tibial prosthesis (ITP) and traditional modular augment prostheses (MAP) in reconstructing AORI Type Ⅲtibial plateau defects, and to provide a reference for clinical decision-making. Methods: A finite element model of AORI Type Ⅲtibial plateau defect (defect area >60%, depth >20mm) was established using CT data of a healthy male subject. Four groups of models were constructed: Spacer, Cone, Sleeve, and ITP. Under different loads (700N, 1750N, 2100N, 2450N, simulating standing, knee flexion, stair climbing, and jogging), the contact stress at the prosthesis-bone interface, vertical displacement of the tibial plateau, and relative micromotion were analyzed. Additionally, a retrospective study was conducted on 6 patients with AORI Type Ⅲdefects who underwent TKA with ITP between January 2021 and January 2025, with clinical evaluation using KSS scores, X-ray imaging, and gait analysis. Results: Biomechanically, under all load conditions, ITP showed lower peak contact stress at the cortical bone, cancellous bone, and prosthesis interfaces (e.g., cortical bone stress at 2100N: 16.69MPa for ITP vs. 30.00MPa for Spacer), smaller vertical displacement (245.6μm at 2100N vs. 385.2μm for Spacer), and reduced relative micromotion (7.1μm at 2100N vs. 13.0μm for Spacer). Clinically, the 24-month follow-up showed that the KSS score increased from 46.5±4.8 preoperatively to 85.4±5.5, with no loosening or osteolysis. Gait parameters (walking speed, step length, cadence) were significantly improved at 1 year postoperatively, and the affected side showed symmetry with the contralateral side.Due to the single-arm small sample size of the clinical cohort (n=6) and the lack of a MAP control group, the clinical findings of this study are only preliminary observations.
Keywords: 3D-printed, Integrated tibial prosthesis, finite element analysis (FEA), Biomechanical evaluation, clinical efficacy, AORI classification
Received: 09 Jul 2025; Accepted: 18 Sep 2025.
Copyright: © 2025 Wang, Zhou and Guo. 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: Lin Guo, gkysgl@126.com
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