Displaying publications 1 - 20 of 141 in total

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  1. Oversized acetabular socket causing groin pain after total hip arthroplasty
    Abbas AA, Kim YJ, Song EK, Yoon TR
    J Arthroplasty, 2009 Oct;24(7):1144.e5-8.
    PMID: 18848418 DOI: 10.1016/j.arth.2008.09.008
    The causes of groin pain after total hip arthroplasty are numerous, and the condition itself is disabling. Therefore, it is imperative that the cause of the pain is identified and managed appropriately. We report a case where the patient had groin pain after total hip arthroplasty as a result of an oversized cementless acetabular component, which caused a breach in the anterior wall of the acetabulum. The anterior wall of the acetabulum was reconstructed with femoral head allograft, and the patient has been symptom free since.
    Matched MeSH terms: Arthroplasty, Replacement, Hip/adverse effects*; Arthroplasty, Replacement, Hip/instrumentation*
  2. Fulltext Apollo total knee replacements in University Malaya Medical Centre: a short-term outcome
    Abbas AA, Merican AM, Kwan MK, Mohamad JA
    Med J Malaysia, 2006 Feb;61 Suppl A:83-7.
    PMID: 17042237
    Total knee arthroplasty is the most preferred option for treatment of severe osteoarthritis of the knee. We report the short-term outcome of 48 total knee replacements in 31 patients utilizing the Apollo Total Knee System after an average follow-up of 48 months (range 15 to 70 months). Records of all patients who underwent TKA using Apollo Total Knee System were retrospectively reviewed. Functional outcome was evaluated using visual analogue scale for pain rating and the Oxford 12-item questionnaire. Postoperative radiographs of the replaced knees were assessed by using the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Degenerative osteoarthritis was the commonest indication for TKA. The average patient's age was 63.7 years (range, 30-77 years). The mean visual analogue scale for pre- and post-operative pain was eight and zero respectively. The mean Oxford 12-item questionnaire score pre- and post-operatively was 44.8 and 16.5 respectively. Patient satisfaction was notable in 98% of the cases with an average improvement in arc of flexion of 111 degrees. There were four failures; deep infection (one) and aseptic loosening (three) giving rise to a 94% implant survivor. The short-term results of this series is comparable with or better than a number of outcome studies of the Apollo Knee System or other implants of similar design.
    Matched MeSH terms: Arthroplasty, Replacement, Knee/methods*
  3. Fulltext Morsellized Allograft and Acetabular Reconstruction Cage: Follow – up of 2 to 9 years
    Abbas, A.A., Merican, A.M., Mohamad, J.A.
    Malays Orthop J, 2007;1(1):5-7.
    MyJurnal
    We report the outcome of 32 patients who underwent total hip replacement (THR) augmented with morsellized fresh frozen femoral head allografts and acetabular reconstruction cages. Nine patients underwent primary THR and 23 patients underwent revision THR. Follow-up ranged from two to 9 years. Two most common indications for the procedures as reported in literature were rheumatoid arthritis and aseptic loosening of the hip. All but one patient achieved good outcome with radiographs showing full incorporation of bone grafts and no evidence of loosening of the implants. Morsellized bone grafting used with acetabular reinforcement devices is valuable for addressing severe acetabular deficiencies.
    Matched MeSH terms: Arthroplasty, Replacement, Hip
  4. Prediction of damage formation in hip arthroplasties by finite element analysis using computed tomography images
    Abdullah AH, Todo M, Nakashima Y
    Med Eng Phys, 2017 06;44:8-15.
    PMID: 28373012 DOI: 10.1016/j.medengphy.2017.03.006
    Femoral bone fracture is one of the main causes for the failure of hip arthroplasties (HA). Being subjected to abrupt and high impact forces in daily activities may lead to complex loading configuration such as bending and sideway falls. The objective of this study is to predict the risk of femoral bone fractures in total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). A computed tomography (CT) based on finite element analysis was conducted to demonstrate damage formation in a three dimensional model of HAs. The inhomogeneous model of femoral bone was constructed from a 79 year old female patient with hip osteoarthritis complication. Two different femoral components were modeled with titanium alloy and cobalt chromium and inserted into the femoral bones to present THA and RHA models respectively. The analysis included six configurations, which exhibited various loading and boundary conditions, including axial compression, torsion, lateral bending, stance and two types of falling configurations. The applied hip loadings were normalized to body weight (BW) and accumulated from 1 BW to 3 BW. Predictions of damage formation in the femoral models were discussed as the resulting tensile failure as well as the compressive yielding and failure elements. The results indicate that loading directions can forecast the pattern and location of fractures at varying magnitudes of loading. Lateral bending configuration experienced the highest damage formation in both THA and RHA models. Femoral neck and trochanteric regions were in a common location in the RHA model in most configurations, while the predicted fracture locations in THA differed as per the Vancouver classification.
    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  5. Fulltext Late asymptomatic medial patella subluxation post total knee arthroplasty
    Abilash Kumar, Jeffrey Jayaraj, Jacob Abraham, Premchandran Menon, Manohar Arumugam
    Borneo Journal of Medical Sciences, 2021;15(1):61-66.
    MyJurnal
    Post-operative complications are well known to impair the functional outcomes of total knee arthroplasty (TKA). Patella subluxations post-TKA is a grim complication rendering patients disable post-surgery. Howbeit, medial patella subluxation is a rarely recorded incident altogether. This case report describes a patient post successful TKA two years ago, who was incidentally diagnosed with a medial patellofemoral subluxation during a recent routine yearly follow up. This gentleman, however, had no complaints and the only evident clinical sign was anterior knee skin puckering. A radiograph of the knee confirmed our clinical suspicion of medial patella subluxation. The patient’s symptoms, his expectations, radiological findings, what went wrong during surgery and management of this rare entity were analysed. This rarely reported entity requires a high degree of suspicion especially if the patient complains of instability and peculiar anterior knee pain. Diagnosis is customarily clinical and revision surgery is almost invariably necessary.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  6. Fulltext Venous thromboembolism prevention protocol for adapting prophylaxis recommendations to the potential risk post total knee replacement: a randomized controlled trial
    Alameri MA, Syed Sulaiman SA, Ashour AM, Al-Saati MF
    Pharm Pract (Granada), 2020 09 22;18(3):2025.
    PMID: 33029262 DOI: 10.18549/PharmPract.2020.3.2025
    Background: Total knee replacement (TKR) is a major orthopedic surgery that is considered high risk for the development of venous thromboembolism (VTE).

    Objective: The aim of this study is to evaluate the clinical outcomes that resulted from the use of a new proposed VTE risk stratification protocol for selecting a suitable extended VTE prophylaxis for post TKR surgery patients administered in conjunction with patient education programs.

    Method: A randomized controlled trial was conducted in two medical centers in Saudi Arabia. A total of 242 patients were enrolled in the study, 121 patients in each group. The experimental group (A) was assessed by using the proposed VTE risk stratification protocol and also took part in patient education programs about TKR and its complications. The control group (B) was assessed by using the 2005 Caprini risk assessment tool and no education programs were given to this group. Both groups were followed for 35 days post operation.

    Results: The mean age of the participants was 65.86 (SD 8.67) and the majority of them were female 137 (56.6%). The mean body mass index of the study sample was 32.46 (SD 5.51). There were no significant differences between the two groups except for surgery type; the proportion of bilateral TKR in group A was higher than in group B (69/121 (28.5%) vs. 40/121(16.5%), p<0.05). There were no confirmed pulmonary embolism cases in the study sample and diagnosis of deep-vein thrombosis was confirmed in 12/242 (5.0%) of patients: 1/121 (0.8%) in group A and 11/121 (9.1%) in group B (p<0.05). The readmission rate for all patients was 2.5% (6/242), all of whom were in group B (p<0.05).

    Conclusion: The proposed VTE risk stratification protocol that was applied in conjunction with patient education programs reduced VTE complications and readmission events, post TKR surgery. Trial Registration: ClinicalTrials.gov: Identifier: NCT04031859.

    Matched MeSH terms: Arthroplasty, Replacement, Knee
  7. Fulltext Clinical pathways: development and implementation at a tertiary hospital in Malaysia
    Aniza Ismail, Saperi Sulung, Syed Mohamed AlJunid, Nor Hamdan Mohd Yahaya, Husyairi Harunarashid, Oteh Maskon, et al.
    Int J Public Health Res, 2012;2(2):153-160.
    MyJurnal
    Clinical pathways have been implemented in many healthcare systems with mix results in improving the quality of care and controlling the cost. CP is a methodology used for mutual decision making and organization of care for a well-defined group of patients within a well-defined period. In developing the CPs for a medical centre, several meetings had been carried out involving expert teams which consist of physicians, nurses, pharmacists and physiotherapists. The steps used to develop the pathway were divided into 5 phases. Phase 1: the introduction and team development, Phase II: determining the cases and information gathering, Phase III: establishing the draft of CP, Phase IV: is implementing and monitoring the effectiveness of CP while Phase V: evaluating, improving and redesigning of the CP. Four CPs had been developed: Total Knee Replacement (TKR), ST Elevation Myocardial Infarction (AMI), Chronic Obstructive Airways Diseases (COAD) and elective Lower Segment Caesarean Section (LSCS). The implementation of these CPs had supported the evidence-based medicine, improved the multidisciplinary communication, teamwork and care planning. However, the rotation of posts had resulted in lack of document ownership, lack of direction and guidance from senior clinical staff, and problem of providing CPs prior to admission. The development and implementation of CPs in the medical centre improved the intra and inter departmental communication, improved patient outcomes, promote patient safety and increased patient satisfaction. However, accountability and understanding of the CPs must be given more attention.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  8. Structured Total Knee Replacement Rehabilitation Programme and Quality of Life following Two Different Surgical Approaches - A Randomised Controlled Trial
    Antony-Leo AP, Arun-Maiya G, Mohan-Kumar M, Vijayaraghavan PV
    Malays Orthop J, 2019 Jul;13(2):20-27.
    PMID: 31467647 DOI: 10.5704/MOJ.1907.004
    Introduction: The key important factor influencing the outcomes following rehabilitation is the surgical approach involved in Total Knee Replacement (TKR). Most studies have analysed the functional outcome in comparing the approaches on surgical perspective rather on post-operative therapeutic interventions. The current study was to analyse the effects of structured TKR rehabilitation programme on the quality of life and joint specific outcomes between two different surgical approaches. Materials and Methods: In this double-blind randomised controlled trial, participants were randomly allocated to one of two groups: Group 1- those who underwent medial parapatellar approach and Group 2- those who underwent mid-vastus approach. Both groups received three-phase structured rehabilitation protocol for 12 weeks. The outcome measures of SF-36, knee mobility, isometric knee musculature strength and six-minute walk distance were measured at baseline, on discharge and at review after three months. Results: The quality of life and joint specific outcome scores were better in mid-vastus approach than the popular medial parapatellar approach. The outcomes of knee flexion mobility (p=0.04), knee extension mobility (p=0.03), isometric muscle strength of quadriceps (p=0.001), isometric muscle strength of hamstrings (p=0.03), six-minute walk distance (p=0.001) and Physical Cumulative Scores (PCS) (p=0.03) were found to exhibit significant improvements at three months follow up. Conclusion: The mid-vastus approach was found to exhibit better improvements following structured rehabilitation care, in physical summary scores of quality of life and joint specific outcomes than medial parapatellar approach.
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  9. Fulltext The levels of depression, anxiety, stress on pre and post knee Arthroplasty patients
    Ardilla Hanim Abdul Razak, Ahmad Hafiz Zulkifly, Ramli Musa, Mohd Shukrimi Awang, Goh, Kian Liang
    International Medical Journal Malaysia, 2017;16(11):39-39.
    MyJurnal
    Total knee arthroplasty represents a major advance in the treatment of
    degenerative joint disease. It provides excellent restoration of joint function and pain
    relief. The primary indication for total knee arthroplasty is to relieve pain caused by
    severe arthritis, with or without significant deformity. This study is to assess
    psychological impact pre and post arthroplasty. (Copied from article).
    Matched MeSH terms: Arthroplasty, Replacement, Knee
  10. Fulltext Early results of Rotating Platform total knee replacement
    Arif M, Makundala V, Choon DSK
    Med J Malaysia, 2005 Jul;60 Suppl C:99-103.
    PMID: 16381292 MyJurnal
    We report on our early experiences with the Press Fit Condylar Rotating Platform (PFC-RP) total knee replacement prosthesis at University Malaya Medical Centre. This new prosthesis was introduced to Malaysia in 2001. It combines the rotating platform technology of Low Contact Stress (LCS) and the modularity of Press Fit Condylar (PFC) system. We performed 18 knee replacements using cruciate retaining prosthesis without patellar resurfacing in 10 patients and followed them up over a period of 16-month. A new operative strategy was developed to match the flexion and extension gaps. The pre- and post-operative assessments were made according to the American Knee Society Scores (AKSS). Post-operative pain relief, range of motion, knee score and functional score showed promising early results. The average knee rating improved from 28 to 91 (range 75-94). Average functional assessment improved from 26 to 82 (range 75-90). The radiographic assessments show correction of an average pre-operative varus of 140 to post-operative valgus of 50 (range 4-70). Early infection occurred in two knees. Both responded to aggressive debridement and antibiotics. Stiffness was encountered in one patient. There were no spinouts of the insert. We are satisfied that the implants are performing well at the one-year mark and will continue monitor this cohort.
    Matched MeSH terms: Arthroplasty, Replacement, Knee*
  11. Revision of total hip arthroplasty using an anterior cortical window, extensive strut allografts, and an impaction graft: follow-up study
    Arif M, Sivananthan S, Choon DS
    J Orthop Surg (Hong Kong), 2004 Jun;12(1):25-30.
    PMID: 15237118
    To report the outcome of revised total hip arthroplasty procedures involving an anterior cortical window, extensive strut allografts, and an Exeter impaction graft.
    Matched MeSH terms: Arthroplasty, Replacement, Hip/adverse effects*; Arthroplasty, Replacement, Hip/methods
  12. Fulltext Painful Pes Anserine Bursitis Following Total Knee Replacement Surgery: Two cases
    Ariff MAM, Ros MIAC, Yahaya NHM
    Sultan Qaboos Univ Med J, 2018 Feb;18(1):e97-e99.
    PMID: 29666689 DOI: 10.18295/squmj.2018.18.01.016
    Pes anserine bursitis (PAB) is an inflammation of the bursa located between the medial aspect of the tibia and the hamstring muscles. It is common in patients with degenerative or inflammatory knee arthritis, usually has a self-limiting course and tends to respond well to conservative treatment. However, painful PAB directly following total knee replacement surgery is rare. We report two such cases who were diagnosed via ultrasonography at the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, in 2015. Both patients were treated locally with triamcinolone acetonide under ultrasound guidance and responded well to treatment.
    Matched MeSH terms: Arthroplasty, Replacement, Knee/adverse effects*
  13. The influence of music therapy on mental well-being among postoperative patients of total knee arthroplasty (TKA)
    Aris A, Sulaiman S, Che Hasan MK
    Enferm Clin, 2019 09;29 Suppl 2:16-23.
    PMID: 31208927 DOI: 10.1016/j.enfcli.2019.04.004
    OBJECTIVE: The objective of this study was to investigate whether music therapy affects immediate postoperative well-being among patients who had undergone TKA surgery in the recovery unit.

    METHOD: A randomized controlled trial was conducted recruiting patients from Hospital Melaka, Malaysia. Postoperative TKA patients with good hearing and visual acuity, fully conscious and prescribed with patients controlled analgesia (PCA) were randomized to either intervention or control groups using a sealed envelope. Patients in the intervention group received usual care with additional music therapy during recovery, while patients in the control group received the usual care provided by the hospital. Two factors identified affecting mental well-being were the pain (measured using numerical rating scale) and anxiety (measured using a visual analog scale) at five different minutes' points (0, 10, 20, 30, and 60).

    RESULTS: A total of 56 (control: 28, intervention: 28) postoperative TKA patients consented in the study. There was no difference in baseline characteristics between the two groups (p>0.05). Using Mann-Whitney U tests, patients in music therapy group showed significantly lower numerical pain score at 60min (p=0.045) whereas there was no significant difference between the two groups at all time points for anxiety scores (p>0.05). In the intervention group, Friedman tests showed that there was a significant difference in numerical pain (χ2=36.957, df=4, p<0.001) and anxiety score across times (χ2=18.545, p=0.001).

    CONCLUSIONS: This study found that pain score decreases over time among patients in the music therapy group while no effect is seen for anxiety. It is suggested that music therapy could not affect postoperative TKA patients' mental well-being. Nonetheless, patients reported better pain score despite the small sample.

    Matched MeSH terms: Arthroplasty, Replacement, Knee/psychology*
  14. Effects of music therapy on physiological outcomes for post-operative total knee arthroplasty (TKA) patients
    Aris A, Sulaiman S, Che Hasan MK
    Enferm Clin, 2021 04;31 Suppl 2:S10-S15.
    PMID: 33849138 DOI: 10.1016/j.enfcli.2020.10.006
    This study aimed to investigate the effects of music on physiological outcomes for post-operative TKA patients in the recovery unit. Fifty-six patients from Hospital Melaka were randomized equally into intervention (IG) and control groups (CG). IG received the usual care and listened to selected music for 60min, while the CG received only the usual care. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiration rate (RR) and oxygen saturation (SpO2) were measured on arrival and after 10, 20, 30, and 60min in the recovery unit. A significant difference between groups was observed in RR upon arrival (U=276.5, p=0.029) and after 10min (U=291, p=0.45). Meanwhile, there were significant differences in DBP (F=3.158, p=0.032), RR (χ2=15.956, p=0.003) and SpO2 (χ2=14.084, p=0.007) over time in the IG. Overall, listening to music immediately after TKA has an effect on DBP, RR, and SpO2.
    Matched MeSH terms: Arthroplasty, Replacement, Knee*
  15. Midterm results of cemented Press Fit Condylar Sigma total knee arthroplasty system
    Asif S, Choon DS
    J Orthop Surg (Hong Kong), 2005 Dec;13(3):280-4.
    PMID: 16365492
    To evaluate the midterm results of 50 patients who underwent total knee replacement using Press Fit Condylar (PFC) Sigma system.
    Matched MeSH terms: Arthroplasty, Replacement, Knee/instrumentation*
  16. Fulltext Morphological study of the newly designed cementless femoral stem
    Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Mohd Noor A
    Biomed Res Int, 2014;2014:692328.
    PMID: 25025068 DOI: 10.1155/2014/692328
    A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.
    Matched MeSH terms: Arthroplasty, Replacement, Hip*
  17. Fulltext Design process of cementless femoral stem using a nonlinear three dimensional finite element analysis
    Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Noor AM, A Harris AR, et al.
    BMC Musculoskelet Disord, 2014;15:30.
    PMID: 24484753 DOI: 10.1186/1471-2474-15-30
    Minimal available information concerning hip morphology is the motivation for several researchers to study the difference between Asian and Western populations. Current use of a universal hip stem of variable size is not the best option for all femur types. This present study proposed a new design process of the cementless femoral stem using a three dimensional model which provided more information and accurate analysis compared to conventional methods.
    Matched MeSH terms: Arthroplasty, Replacement, Hip/instrumentation*
  18. Fabrication of low-cost, cementless femoral stem 316L stainless steel using investment casting technique
    Baharuddin MY, Salleh ShH, Suhasril AA, Zulkifly AH, Lee MH, Omar MA, et al.
    Artif Organs, 2014 Jul;38(7):603-8.
    PMID: 24404766 DOI: 10.1111/aor.12222
    Total hip arthroplasty is a flourishing orthopedic surgery, generating billions of dollars of revenue. The cost associated with the fabrication of implants has been increasing year by year, and this phenomenon has burdened the patient with extra charges. Consequently, this study will focus on designing an accurate implant via implementing the reverse engineering of three-dimensional morphological study based on a particular population. By using finite element analysis, this study will assist to predict the outcome and could become a useful tool for preclinical testing of newly designed implants. A prototype is then fabricated using 316L stainless steel by applying investment casting techniques that reduce manufacturing cost without jeopardizing implant quality. The finite element analysis showed that the maximum von Mises stress was 66.88 MPa proximally with a safety factor of 2.39 against endosteal fracture, and micromotion was 4.73 μm, which promotes osseointegration. This method offers a fabrication process of cementless femoral stems with lower cost, subsequently helping patients, particularly those from nondeveloped countries.
    Matched MeSH terms: Arthroplasty, Replacement, Hip/economics
  19. Fulltext Avascular Necrosis of the Hip in Primary Care
    Baharum NN, Ariffin F, Hanafiah M, Sulaiman SH
    Korean J Fam Med, 2021 Jan;42(1):84-87.
    PMID: 32447880 DOI: 10.4082/kjfm.19.0021
    Avascular necrosis, or osteonecrosis of the femoral head, is a debilitating condition which leads to the destruction of the hip joint due to an interruption in the blood supply to the bony region and is most commonly due to trauma. The case discussed here has been highlighted as it presented as non-traumatic osteonecrosis of the femoral head with an absence of risk factors in a healthy adult male. A 37-year-old male presented with a 4-month history of recurrent left hip pain, which worsened with initiation of movement and weightbearing on the affected side. The patient was overweight but normotensive with a full range of movement of the hips bilaterally. There were no abnormalities detected on initial X-ray images of the left hip. However, due to the persistent pain and sclerotic changes in a subsequent X-ray, a magnetic resonance image of the bilateral hips was obtained, leading to the diagnosis of osteonecrosis of the bilateral femoral heads. Due to the lack of improvement with physiotherapy and analgesia, the patient was subjected to conservative surgery of the symptomatic left hip with concurring evidence of avascular necrosis based on intraoperative anatomical biopsy. This case emphasizes the importance of identifying underlying issues during history taking and physical examination in adults without risk factors. The early diagnosis of osteonecrosis assists in preventing joint collapse and can delay the requirement of joint replacements. High levels of suspicion are necessary to instigate investigation in persistent cases without the presence of risk factors.
    Matched MeSH terms: Arthroplasty, Replacement
  20. Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis
    Bajuri MN, Abdul Kadir MR, Murali MR, Kamarul T
    Med Biol Eng Comput, 2013 Feb;51(1-2):175-86.
    PMID: 23124814 DOI: 10.1007/s11517-012-0982-9
    The total replacement of wrists affected by rheumatoid arthritis (RA) has had mixed outcomes in terms of failure rates. This study was therefore conducted to analyse the biomechanics of wrist arthroplasty using recently reported implants that have shown encouraging results with the aim of providing some insights for the future development of wrist implants. A model of a healthy wrist was developed using computed tomography images from a healthy volunteer. An RA model was simulated based on all ten general characteristics of the disease. The ReMotion ™ total wrist system was then modelled to simulate total wrist arthroplasty (TWA). Finite element analysis was performed with loads simulating the static hand grip action. The results show that the RA model produced distorted patterns of stress distribution with tenfold higher contact pressure than the healthy model. For the TWA model, contact pressure was found to be approximately fivefold lower than the RA model. Compared to the healthy model, significant improvements were observed for the TWA model with minor variations in the stress distribution. In conclusion, the modelled TWA reduced contact pressure between bones but did not restore the stress distribution to the normal healthy condition.
    Matched MeSH terms: Arthroplasty, Replacement*
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