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The effect of varus tilt on contact stresses in total knee arthroplasty: a biomechanical study.

The contact stress produced in the tibiofemoral joint from a varus-tilted tibial component was tested in five total knee prostheses. Peak and mean stresses were measured with a digital electronic sensor under compressive load at 15 degrees and 90 degrees flexion. Stresses were measured with the tibial component tilted 0 degrees and 5 degrees in the mediolateral direction. At a 5 degree tilt, the Advantim, the Miller-Galante II, and the Omnifit prostheses, which have a flat configuration on the femoral and tibial surfaces in the coronal plane, had significantly greater stresses than the LCS and the Profix prostheses, which have tibial and femoral components with matching curved surfaces in the coronal plane. These results suggest that the femoral component surface should have a radius of curvature that matches that of the tibial articular surface in the coronal plane to achieve a large contact area even in varus-valgus tilting.