Finite element analysis for the biomechanical effect of tibial insert materials in total knee arthroplasty

Instability and wear are the most common causes of failure of total knee arthroplasty (TKA). The purpose of this study is to evaluate the biomechanical effects on knee joints of different tibial insert materials: UHMWPE, PEEK and CFR-PEEK. The forces exerted on soft tissues were evaluated under a deep knee bend condition in posterior-stabilized (PS) and cruciate-retaining (CR) TKA. The efficacy of quadriceps muscle force in flexion, in both TKA, was reduced when the tibial insert material was changed to PEEK and CFR-PEEK. There was no difference in the collateral ligament force in PS TKA. However, the medial collateral ligament force was greater with PEEK and CFR-PEEK than UHMWPE in CR TKA. The posterior cruciate ligament force was lower with PEEK and CFR-PEEK than UHMWPE. Our results showed that PEEK and CFR-PEEK can be alternative materials to existing UHMWPE, but it should be careful to adapt them in CR TKA.