Background: There is a gradual increase in the number of patients for total knee arthroplasty (TKA), and TKA demonstrates reliable clinical outcomes. The orthopaedic biomaterials community continuously attempted over the past decades to improve the longevity of UHMWPE in TKA by using various improved technologies. Polyetheretherketone (PEEK) and carbon fiber reinforced-PEEK(CFR-PEEK) are suggested as potential tibial insert materials to replace UHMWPE in some applications. The aim of this study involves evaluating the biomechanical effects of UHMWPE and CFR-PEEK tibial materials on mobile-bearing TKA. Methods: The finite element (FE) model was obtained by conducting computed tomography and magnetic resonance imaging. The FE investigation included three types of loading conditions corresponding to the loads used in the experiments for FE model validation and model predictions under deep-knee bend loading conditions. We investigated forces on quadriceps, collateral ligament and patellar tendon with UHMWPE and CCFR-PEEK tibial insert materials under the deep-knee-bend condition. Results: Quadriceps force decreased with flexion for CFR-PEEK when compared to that for UHMWPE. A similar trend was observed in terms of the patellar tendon force. An opposite trend was observed in the collateral ligament. Medial collateral ligament force in the CFR-PEEK exceeded that in the UHMWPE, and lateral collateral ligament force in the UHMWPE exceeded that in the CFR-PEEK. Conclusion: The CFR-PEEK represents an alternative insert material given its superior biomechanical effect after mobile-bearing total knee arthroplasty. However, a balance between the medial and lateral ligaments is considered as an important factor in the CFR-PEEK tibial insert due to its opposite biomechanical effect.
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