Contact stress at articular surfaces in total joint replacements. Part II: Analytical and numerical methods

In this second part of the series of reviews, attention focuses on analytical and numerical methods that have been used to estimate the magnitude of the contact stress in: models of articular joints; models of total joint replacements, without and with the associated joint; or models of simple physical systems that are deemed to have relevance to conditions at articular surfaces in arthroplasties. Three main recommendations emerge from this review. First, analytical methods should be avoided. Second, for numerical studies, the nonlinear contact finite element method should be used. Third, more work is needed in many areas, an example of which is the effect of the method of sterilization of tibial inserts on the estimated contact stress at the tibiofemoral interface in knee implants.