Stress shielding in periprosthetic bone following a total knee replacement: Effects of implant material, design and alignment

For the cases examined, the effect of stress shielding on the periprosthetic bone seems to be more significantly influenced by the implant material than by the implant geometry. Significant stress shielding is found in MB cases, as opposed to increase in bone density found in AP cases, particularly in the bones immediately beneath the baseplate. The effect of stress shielding is reduced somewhat for the MB components in the malaligned positions compared with the neutral case. In AP cases, the effect of stress shielding is mostly low except in the varus position, possibly due to off-loading of lateral condyle. Increases in bone density are found in both MB and AP cases for the malaligned conditions.