Individualized and accurate implantation of a tibial prosthesis during total knee arthroplasty (TKA) can assist in uniformly distributing the load and reducing the polyethylene wear to obtain a long-term prosthetic survival rate, but individualized and accurate implantation of a tibial prosthesis during TKA remains challenging. The purpose of this study was to optimize and individualize the positioning parameters of a tibial prosthesis to improve its accurate implantation using a new method of finite element analysis in combination with orthogonal experimental design. Ten finite element models of TKA knee joint were developed to optimize the implantation parameters (varus angle, posterior slope angle, and external rotation angle) of tibial prosthesis to reduce the peak value of the contact pressure on the polyethylene liner according to the method of finite element analysis in combination with orthogonal experimental design. The influence of implantation parameters on the peak value of the contact pressure on the polyethylene liner was evaluated based on a range analysis in orthogonal experimental design. The optimal implantation parameters for tibial prosthesis included 0° varus, 1° posterior slope, and 4° external rotation. Under these conditions, the peak value of the contact pressure on the polyethylene liner remained the smallest (16.37 MPa). Among the three parameters that affect the peak value of the contact pressure, the varus angle had the greatest effect (range = 6.70), followed by the posterior slope angle (range = 2.36), and the external rotation angle (range = 2.15). The optimization method based on finite element analysis and orthogonal experimental design can guide the accurate implantation of the tibial prosthesis, reducing the peak value of the contact pressure on the polyethylene liner. This method provides new insights into the TKA preoperative plan and biomechanical decision-making for accurately implanting TKA prosthesis.

中文翻译：

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基于有限元分析和正交试验设计的个性化TKA胫骨假体植入参数优化方法

全膝关节置换术（TKA）期间个体化和准确地植入胫骨假体可以帮助均匀地分配载荷并减少聚乙烯磨损，从而获得长期的假体存活率，但是在TKA期间个体化和精确地植入胫骨假体仍然具有挑战性。这项研究的目的是优化和个性化胫骨假体的定位参数，以结合新的有限元分析方法和正交实验设计来提高其准确植入率。开发了十个TKA膝关节有限元模型以优化植入参数（内翻角，后倾斜角，有限元分析方法并结合正交实验设计，以减小胫骨假体的最大压力和最大外旋转角）来降低聚乙烯衬里上的接触压力的峰值。基于正交实验设计中的范围分析，评估了注入参数对聚乙烯衬里接触压力峰值的影响。胫骨假体的最佳植入参数包括内翻0°，后倾斜1°和外旋4°。在这些条件下，聚乙烯衬里上的接触压力的峰值保持最小（16.37 MPa）。在影响接触压力峰值的三个参数中，内翻角影响最大（范围= 6.70），其次是后倾斜角（范围= 2.36），和外部旋转角度（范围= 2.15）。基于有限元分析和正交实验设计的优化方法可以指导胫骨假体的准确植入，降低聚乙烯衬里上的接触压力峰值。该方法为准确植入TKA假体提供了有关TKA术前计划和生物力学决策的新见识。