Biomechanical optimization study of posterior tilt extension stems in the repair of tibial plateau bone defects

Based on the finite element analysis results, this study provides a hypothetical reference for the selection of posterior tilt angles of extension stems in the repair of tibial plateau defects: a posterior tilt angle of ≤7° is suggested for 20% defects when using a 40 mm stem; 7°-10° for 40% defects when using an 80 mm stem; and 5°-7° for 60% defects when using an 80 mm stem. This preliminary biomechanical finding offers a basis for exploring personalized implant design, while the realization of precision-based repair and improved prosthesis longevity requires further validation by multi-center clinical data, diverse patient anatomical models (e.g., differences in tibial size and medullary canal morphology), and <i>in vitro</i> experiments.These data need to be verified through multi-center clinical data and <i>in vitro</i> artificial bone experiments.