Analysis Design of 3D Printed Tensioner Ligament Guide in Total Knee Arthroplasty Based on Gap Balancing Technique

DOI: 10.14416/j.ind.tech.2022.07.002

Abstract

Thailand is entering the ageing society hence the number of total knee arthroplasty (TKA) surgeries is increasing every year. Implant alignment and soft-tissue balancing are important success factors in total knee arthroplasty. The goal of the gap balancing technique is to recreate symmetric and rectangular flexion and extension spaces both medial and lateral. This research aims to optimize the design of a cutting tool guide for total knee arthroplasty based on the gap balancing technique.  The cutting guide was designed to measure ligament force and the gap distance on the medial and lateral sides. The guide was created using 3-dimension printing (3D printing). The finite element model of the guide under ligament loading was constructed. The finite element method (FEM) was then verified and validated with the experiment and the results agreed well. The influence of the guide parameters was examined using the Taguchi method. Four parameters, namely the width, height, base-knee length, and base-support length were investigated. The Taguchi main effect analysis and ANOVA results show that the height and base-support length are the most important factor. Applying the Taguchi method and using the minimum displacement as the design criteria, the optimum guide design was identified.  The verified finite element model and the experimental test of the 3D printed cutting guide using the optimum design were conducted.