Analysis of the Kinematics of Total Knee Prostheses With a Medial Pivot Design

Miyazaki, Yoshiyasu; Nakamura, Takashi; Kogame, Katsunori; M, Saito; Yamamoto, Kazuhisa; Suguro, Toru

doi:10.1016/j.arth.2010.08.015

Cited by 68 publications

(51 citation statements)

References 5 publications

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“…One medial-pivot TKA design has demonstrated up to 10°tibial internal rotation at 100°flexion and lateral femoral rollback of 7.3 mm [16], which was confirmed by Schmidt et al [21] who measured rollback of 3 mm. One asymmetric CR-TKA design demonstrated tibial internal rotation of 1.4°and lateral rollback [2].…”

Section: Introductionmentioning

confidence: 65%

“…The ease of bending the knee 3 years postoperatively compared to 1 year may be the reason for the different positions. In vivo fluoroscopic studies avoid this problem by selecting the frames in 10°to 30°increments [2,4,5,13,16,17,23,24] at certain flexion angles. Second, our radiographs in flexion were nonweightbearing.…”

Section: Discussionmentioning

confidence: 99%

“…Schmidt et al [21] studied five patients with a medial-pivot CR-TKA design and found a medial-pivot motion in three of the five knees with tibial internal rotation of 2.2°during gait. Miyazaki et al [16] reported on 29 medial-pivot CR-TKA and observed postoperative flexion of 130.6°with an average of 10°of tibial internal rotation. Mannan and Scott [15] reported on 10-year results of 228 medial-pivot TKAs using a different design and found no improvement in flexion compared to other published CR-TKA results.…”

Section: Discussionmentioning

confidence: 99%

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Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Fitz¹,

Sodha

Reichmann

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Normal knee kinematics is characterized by posterior femorotibial rollback with tibial internal rotation and medial-pivot rotation in flexion. Cruciate-retaining TKAs (CR-TKAs) do not reproduce normal knee kinematics. Questions/purposes We hypothesized a more anatomic reconstruction of the medial femoral condyle, simultaneously preserving the tension of the PCL and medial collateral ligament, resulted in (1) medial-pivot rotation and tibial internal rotation, (2) lateral femoral rollback, and (3) reduced liftoff. Patients and Methods We compared 10 patients who underwent CR-TKA using the new technique at their 1-year followup to a matched control group of nine patients using a traditional gap-balancing technique at their 2-to 4-year followup. All patients received lateral radiographs in extension and flexion, which we utilized for threedimensional implant matching to calculate tibial internal rotation, lateral rollback, and lateral liftoff in extension and flexion. Results The new gap-balancing technique resulted in a median of 3.5°tibial internal rotation with 2.7-mm rollback of the lateral femoral condyle relative to the medial condyle in flexion, which was different from the control group. We found no differences in liftoff between the groups. Conclusions The new technique resulted in tibial internal rotation with flexion and lateral rollback comparing the lateral to the medial condyle in flexion, but no differences in condylar liftoff. These preliminary results were comparable to published kinematic results of an asymmetric CR-TKA or medial-pivot CR-TKA but not to symmetric CR-TKA.

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Section: Introductionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Fitz¹,

Sodha

Reichmann

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…Theoretically, ADVANCE MP TKA induces a medial pivot motion and does not allow posterior rollback as in the post and cam mechanism. However, Miyazaki et al reported that the lateral condyle showed anterior movement in the early stage, changing thereafter to posterior movement, in contrast to the fixed medial condyle in ADVANCE TKA [12]. The report suggested that this prosthesis had a relatively low medial pivot motion at lower flexion angle.…”

Section: Discussionmentioning

confidence: 87%

“…Among several types of prosthesis, ADVANCE Medial-pivot (MP) TKA (Wright Medical Technology, Arlington, TN) has a unique design concept compared to cruciate retaining (CR), and posterior stabilised (PS) prostheses in that it aims to replicate the medial pivoting behaviour observed in normal knees and has been found to exhibit excellent anterior-posterior (AP) stability. Several studies have revealed in vitro and in vivo tibio-femoral kinematics of this prosthesis and reported its favourable performance for patients; however, details about the performance of the PF joint remain unknown at present [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

Chinzei

Ishida

Matsumoto

et al. 2013

International Orthopaedics (SICOT)

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Purpose ADVANCE® Medial Pivot (MP) (Wright Medical) total knee arthroplasty (TKA) was established to replicate normal tibio-femoral knee joint kinematics, however, its influence on the patello-femoral (PF) joint is unclear. The purpose in this study was to assess the PF joint conditions in Advance MP TKA, via radiography and three-dimensional image-matching software. Methods Ten subjects with osteoarthritis were treated with the ADVANCE MP TKA. Pre-operatively and one month after surgery, skyline views at 30, 60, and 90°of flexion were taken, and patella shift and tilt were measured. With 2D-3D registration techniques using software, implant orientations were matched with the pre-operative CT and changes in the anterior part of the femoral prosthesis, condylar twist angle (CTA) for femoral rotation, and tibial rotation were evaluated. The relationships between morphological and rotational changes were evaluated. Results There were significant differences in patella tilt at 60°a nd patella shift at all angles between pre-and post-operation (p<0.05). No correlation was found between morphological changes in the anterior femur with patella tilt and shift. A positive correlation between postoperative CTA and patella shift at 90°was found (p<0.05); however, no correlation was found between rotational alignment of the tibial component and patella tilt and shift. Conclusions ADVANCE MP TKA changed patello-femoral joint kinematics, compared to that found before surgery. The kinematic features were mainly due to the design concepts for tibio-femoral joint motion, indicating the difficulty to reproduce normal patello-femoral joint kinematics after TKA.

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Mobile bearing shows larger rollback motion than fixed bearing in total knee arthroplasty using a medial stabilising technique with a navigation system

Tsushima,

Sasaki,

Sasaki

et al. 2024

J. exp. orthop.

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PurposeThis study aimed to investigate the intraoperative knee kinematics of cruciate‐retaining total knee arthroplasty with a medial stabilising technique (MST‐TKA) and compare the kinematics between mobile‐ and fixed‐bearing MST‐TKAs. We hypothesised that mobile‐bearing MST‐TKA would result in greater physiological kinematic motion than fixed‐bearing MST‐TKA.MethodsTwenty‐one and 20 knees underwent mobile‐ and fixed‐bearing MST‐TKAs using a navigation system (Orthopilot® ver. 6.0; B. Braun Aesculap), respectively. In the preoperative and postoperative kinematic analysis, the knee was moved manually from 0° to 120°, and femoral anteroposterior translations of the medial femoral condyle (MFC) and lateral femoral condyle (LFC) were recorded every 0.1 s from 0° to 120°. Data were subsequently extracted from the software every 10° of flexion and compared between the two groups, and the correlation coefficients between preoperative and postoperative kinematics were calculated.ResultsIn the postoperative analysis, the MFC in the mobile‐bearing group showed significant posterior translation at 100°, 110° and 120° compared to the fixed‐bearing group (p < 0.01). Similarly, the LFC in the mobile‐bearing group showed significant posterior translation at 100°, 110° and 120° compared to the fixed‐bearing group (p < 0.05, p < 0.01 and p < 0.05, respectively). In the mobile‐bearing group, the preoperative and postoperative anteroposterior translations of the MFC and LFC were correlated (p < 0.01), while in the fixed‐bearing group, there was no correlation.ConclusionThe femoral rollback motion in the mobile‐bearing MST‐TKA correlated with the preoperative kinematics and was larger than that in the fixed‐bearing group.Level of EvidenceLevel II, therapeutic prospective cohort study.

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Analysis of the Kinematics of Total Knee Prostheses With a Medial Pivot Design

Cited by 68 publications

References 5 publications

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

Mobile bearing shows larger rollback motion than fixed bearing in total knee arthroplasty using a medial stabilising technique with a navigation system

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