The physiological basis for a flexible condylar tibial plateau design.

Abstract Knee resurfacing is a successful treatment for osteo- and rheumatoid arthritis in elderly patients. The application of this treatment to younger more active and obese persons has the potential to produce premature wear, loosening, and undesirable bone remodelling. A new generation of more physiologically compatible components is required for these situations. This paper discusses the design and analysis of a prototype tibial base plate aimed at physiological load transfer. Incorporated in the design are mechanisms to alleviate lift-off phenomena, bone stress concentrations, stress shielding, and micromotion at the bone-implant interface. The design requires viable cancellous bone stock, so that the bone may respond by remodelling to the dynamic loading during normal ambulatory activities.