Comparing navigation-based in vivo knee kinematics pre- and postoperatively between a cruciate-retaining and a cruciate-substituting implant

Baier, Christel; Springorum, Hans-Robert; Götz, Jürgen; Schaumburger, Jens; Lüring, C.; Grifka, Joachim; Beckmann, Johannes

doi:10.1007/s00264-013-1798-4

Cited by 29 publications

(25 citation statements)

References 33 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[2] and Baier et al. [4] confirmed that the anterior instability during mid-flexion reported by Victor et al. [1], which is due to paradoxical anterior femoral translation of the medial condyle, is commonly seen in CR TKA.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Case series report of navigation-based in vivo knee kinematics in total knee arthroplasty with a gradually reducing femoral radius design

Takagi

Asai

Sato

et al. 2017

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

BackgroundSimulations show that paradoxical anterior femoral slide in conventional dual radius total knee arthroplasty (TKA) is initiated by sudden reduction of the femoral radius from distal to posterior. Therefore, we hypothesized that a new TKA prosthesis design with a gradually reducing femoral radius may minimize the anterior slide in navigation-based in vivo knee kinematics. The purpose of this study was to compare the kinematics of TKA in vivo using a prosthesis with a gradually reducing radius, in comparison with the conventional dual radius design.MethodsA retrospective case series report was performed for 12 knees with osteoarthritis using a CT-free navigation system. Six knees received TKA using a prosthesis with a gradually reducing femoral radius (Attune CR) and the other 6 knees underwent TKA using a conventional dual radius design (PFCΣ CR). Anterior-posterior (AP) displacement of the medial and lateral femoral condyles relative to the tibia, and kinematic patterns of the femur throughout the range of motion were compared between the groups.ResultsThe average AP displacement in the Attune CR group indicated no paradoxical anterior movement of both condyles, and kinematic data showed a medial pivot pattern. In contrast, AP displacement in the PFCΣ CR group indicated that both condyles showed paradoxical anterior movement, and kinematically both condyles moved in the same manner, showing a parallel motion pattern.ConclusionTKA using a prosthesis with a gradually reducing radius minimized paradoxical anterior slide in navigation-based in vivo knee kinematics.

show abstract

Section: Discussionsupporting

confidence: 89%

“…reported slight mid-flexion instability in CR compared with PS TKA [4], and Massin et al. detected paradoxical displacements in hyper congruent prostheses [5].…”

Section: Introductionmentioning

confidence: 94%

Case series report of navigation-based in vivo knee kinematics in total knee arthroplasty with a gradually reducing femoral radius design

Takagi

Asai

Sato

et al. 2017

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…This motion sequence could, however, only be tracked when the anterior-cruciate ligament was intact [1]. Knee kinematics after TKA revealed a variety of movement patterns, including almost physiological sequences but also paradoxical forward slide of the femoral condyles during flexion [3,13,22]. Regardless of cruciate-retaining or cruciate-substituting implants, normal knee kinematics are rarely observed [13,31].…”

Section: Discussionmentioning

confidence: 99%

Improved kinematics of total knee replacement following partially navigated modified gap-balancing technique

Baier

Fitz

Craiovan

et al. 2013

International Orthopaedics (SICOT)

Self Cite

View full text Add to dashboard Cite

Purpose Navigation-based total knee arthroplasty (TKA) has proven its value for restoration of the limb axis. However, patient-orientated results after TKA show a wide variation from the correct implantation technique. Nonphysiological kinematics without posterior femoral rollback and tibial internal rotation in flexion could be one reason for this. We postulated that a modified gap-balancing technique with navigation of the tibia alone, in comparison to a conventional navigated technique, would: (1) obtain lateral femoral rollback, (2) alter condylar liftoff without midflexion instability, (3) significantly differ in femoral and tibial cuts, (4) not be inferior in leg-axis restoration and (5) be comparable in clinical short-term scores. Methods In this prospective study, we compared in vivo navigation-based kinematics pre-and postoperatively of 40 consecutive TKA comprising 21 conventional navigationbased TKA and 19 TKA with the modified gap-balancing technique and a reduced navigation workflow. All cuts were double checked and compared with cuts proposed by the navigation system. Clinical results were assessed preoperatively and six months postoperatively. Results The modified gap-balancing technique resulted in significantly increased lateral femoral rollback (mean 16.3 mm) and lateral condylar liftoff (mean 1.3 mm) compared to the conventional group. The modified technique comprised an average of 2.1 mm less distal femoral resection and an average of 4°less external rotation and 3.5°more flexion of the femoral component compared with the control group. Average tibial resection height was 1.1 mm greater and average tibial slope was 0.5°elevated compared to the control group. A neutral leg axis was achieved in all cases. Results showed no significant differences in clinical scores between groups. Conclusion A partial navigation solely of the tibial cut can securely restore the leg axis. Modification of the surgical technique can possibly reproduce more physiological knee kinematics with higher lateral femoral rollback in flexion without midflexion instability. This might help reduce postoperative problems with the new implant and thus reduce the amount of unsatisfactory results. Despite equal short-term results, mid-to long-term results are needed to prove whether or not this correlates with better clinical results and at least equal implant longevity.

show abstract

“…Numerous studies have been conducted to investigate the kinematics of the knee after TKA . Early studies performed investigation of TKA kinematics using motion analysis system to quantify the 6DOF kinematics of the TKA knees and compared the data to normal knees .…”

mentioning

confidence: 99%

Articular contact kinematics of the knee before and after a cruciate retaining total knee arthroplasty

Hosseini

Tsai

et al. 2014

Journal Orthopaedic Research

View full text Add to dashboard Cite

Accurate knowledge of tibiofemoral articular contact kinematics of the knee after total knee arthroplasty (TKA) is important for understanding the intrinsic knee biomechanics and improving the longevity of the components. The objective of this study was to compare the in vivo articular contact kinematics of the knees with end-stage medial osteoarthritis (OA) during a weightbearing, single leg lunge activity before and after a posterior cruciate retaining TKA (CR-TKA) using a dual fluoroscopic imaging technique. We found that the CR-TKA resulted in more posterior contact positions on the tibial surface and a reduced range of motion in the medial and lateral compartments. The distances between medial and lateral contact locations in the CR-TKA knees were statistically larger than the OA knees. The articular contact centers have shifted from medial side of the tibial plateau pre-operatively to the lateral side after operation. This study indicated that the CR-TKA resulted in significant changes in contact kinematics of the knees in both anteroposterior and mediolateral directions. Keywords: TKA; knee osteoarthritis; fluoroscopy; in vivo kinematics; contact kinematics Contemporary total knee arthroplasty (TKA) aims to reduce pain and restore function of the knee with severe osteoarthritis (OA) and other end-stage knee joint diseases.1,2 Recently, many innovative component designs have been introduced to enhance knee joint flexion and improve longevity of the prosthesis. [3][4][5][6][7] Although satisfactory clinical follow up data has been reported, 1,8 there are also data showing persistent difficulties or pain during motion in patients postoperatively. 1,9 Polyethylene wear related problems have been reported to be a leading cause for re-operation. 1,8,[10][11][12] Various factors, such as component design and surgical implantation, have been attributed to post-operative complications. 10,11,13 Abnormal knee kinematics following TKA has been thought to alter intrinsic knee joint biomechanics and lead to suboptimal patient satisfaction. 10 Numerous studies have been conducted to investigate the kinematics of the knee after TKA.3,14-18 Early studies performed investigation of TKA kinematics using motion analysis system to quantify the 6DOF kinematics of the TKA knees and compared the data to normal knees. 19,20 Many studies also used cadaveric specimens to compare the TKA kinematics with that of native knees under controlled conditions. 21,22 In-vivo articular contact forces have been measured using implanted force sensors. 23,24 Recently, fluoroscopic imaging technique has been widely used to investigate medial and lateral condyle motions of the knee after TKAs.18,25-27 While these studies greatly improved our knowledge on TKA biomechanics, the changes on articular contact locations after TKA compared to those measured on the knee before operation have not been reported. This information could provide further insight on how intrinsic biomechanics of the knee is altered after the surgery.Therefore, the obj...

show abstract

Comparing navigation-based in vivo knee kinematics pre- and postoperatively between a cruciate-retaining and a cruciate-substituting implant

Cited by 29 publications

References 33 publications

Case series report of navigation-based in vivo knee kinematics in total knee arthroplasty with a gradually reducing femoral radius design

Case series report of navigation-based in vivo knee kinematics in total knee arthroplasty with a gradually reducing femoral radius design

Improved kinematics of total knee replacement following partially navigated modified gap-balancing technique

Articular contact kinematics of the knee before and after a cruciate retaining total knee arthroplasty

Contact Info

Product

Resources

About