Rapid Estimation of Contact Stresses in Imageless Total Knee Arthroplasty

Total knee arthroplasty (TKA) is a surgical technique to replace damaged knee joints with artificial implants. Recently, the imageless TKA has brought a revolutionary improvement to the accuracy of implant placement and ease of surgical process. Based on key anatomical points on the knee, the software guides the surgeon during the TKA procedure. However, the number of revision surgeries is increasing due to malalignment caused by registration error, resulting in imbalanced contact stresses that lead to failure of the TKA. Conventional stress analysis methods involve time-consuming and computationally demanding finite element analysis (FEA). In this work, a machine-learning-based approach estimates the contact pressure on the TKA implants. The machine learning regression model has been trained using FEA data. The optimal preprocessing technique was confirmed by the data without preprocessing, data divided by model size, and data divided by model size and optimal angle. Extreme gradient boosting, random forest, and extra trees regression models were trained to determine the optimal approach. The proposed method estimates the contact stress instantly within 10 percent of the maximum error. This has resulted in a significant reduction in computational costs. The efficiency and reliability of the proposed work have been validated against the published literature.

Automated summary

Total knee arthroplasty (TKA) is a surgical technique that replaces damaged knee joints with artificial implants. Imageless TKA has greatly improved the accuracy of implant placement and surgical process ease. However, malalignment caused by registration error can lead to increased revision surgeries and failure of the TKA. This study proposes a machine learning-based approach to estimate contact pressure on TKA implants, reducing computational costs and providing reliable estimations.