Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

Sumner, Bonnie; McCamley, John; Jacofsky, David J.; Jacofsky, Marc C.

doi:10.1055/s-0039-1692652

Cited by 3 publications

(2 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, abruptly moving from a large to a small radius during mid‐flexion was claimed to lead to transient collateral ligament slackness and paradoxical anterior translation of the femur 16 . A single‐radius (SR) and gradually increasing radius (G‐curve) design were introduced to address this mid‐flexion instability, which studies have suggested allow for more normal kinematics compared to the J‐curve design 17‐21 . No long‐term outcome studies have confirmed the superiority of these designs over the J‐curve.…”

Section: Introductionmentioning

confidence: 99%

“…16 A single-radius (SR) and gradually increasing radius (G-curve) design were introduced to address this mid-flexion instability, which studies have suggested allow for more normal kinematics compared to the J-curve design. [17][18][19][20][21] No long-term outcome studies have confirmed the superiority of these designs over the J-curve. Despite this, tibial component geometry likely plays a larger role in knee kinematics, as illustrated by the very different constraints provided by surfaces with low and high conformity.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The effect of total knee geometries on kinematics: An experimental study using a crouching machine

Walker

Mhadgut

Buchalter

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

Obtaining anatomic knee kinematics after a total knee is likely to improve outcomes. We used a crouching machine to compare the kinematics of standard condylar designs with guided motion designs. The standard condylars included femoral sagittal radii with constant radius, J‐curve and G‐curve; the tibial surfaces were of low and high constraint. The guided motion designs were a medial pivot and a design with asymmetric condylar shapes and guiding surfaces. The machine had a flexion range from 0° to 125°, applied quadriceps and hamstring loading, and simulated the collateral soft tissues. The kinematics of all standard condylar knees were similar, showing only small anterior–posterior displacements and internal–external rotations. The two asymmetric designs showed posterior displacements during flexion, but less axial rotations than anatomic knees. The quadriceps forces throughout flexion were very similar between all designs, reflecting similar lever arms. It was concluded that standard condylar designs, even with variations in sagittal radii, are unlikely to reproduce anatomic kinematics. On the other hand, designs with asymmetric constraint between medial and lateral sides, and other guiding features, are likely to be the way forward. The mechanical testing method could be further improved by superimposing shear forces and torques during the flexion–extension motion, to include more stressful in vivo functional conditions.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

The effect of total knee geometries on kinematics: An experimental study using a crouching machine

Walker

Mhadgut

Buchalter

et al. 2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

Medial‐pivot design does not provide superior clinical results compared to posterior‐stabilized total knee arthroplasty despite kinematic differences during step‐up and lunge activities: A prospective randomized controlled trial under medial tight soft tissue balance

Nakamura,

Okamoto,

Masuda

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThis study aimed to compare in vivo kinematics during weight‐bearing daily activities and determine the relationship with clinical outcomes in patients undergoing total knee arthroplasty (TKA) with a medial‐pivot (MP, Evolution™) versus a posterior‐stabilized (PS, Persona®) design under constant conditions of intraoperative soft tissue balance.MethodsForty patients undergoing MP or PS‐TKA under similar conditions of soft tissue balance were enrolled in this prospective randomized controlled trial. Outcome measures included clinical knee society scores (KSS) and knee injury and osteoarthritis outcome scores (KOOS). A kinematic assessment was conducted while the participants performed lunge and step‐up activities under fluoroscopic guidance.ResultsEighteen patients in each arm completed 1‐year follow‐up and were included in the analysis. All patients experienced pain relief and satisfactory knee function postoperatively. In kinematics, in the MP arm, the medial femoral condyle remained consistent, whereas the lateral femoral condyle gradually shifted posteriorly with increasing knee flexion. Conversely, in the PS arm, paradoxical anterior movement of the medial femoral condyle accompanied the lateral pivot motion. During lunge and step‐up activities, a medial‐pivot motion was observed in 83% and 72% of knees in the MP arm, respectively, compared with 22% and 11% in the PS arm. Despite these differences in kinematics, there were no statistically significant differences in the KSS and KOOS between the two groups.ConclusionUnder weight‐bearing conditions during flexion, knees that underwent Evolution™ MP‐TKA did not show superior clinical results compared to Persona® PS‐TKA, despite exhibiting in vivo kinematics closely resembling the normal in vivo pattern.Level of EvidenceTherapeutic studies—Level I.

show abstract

Alterations of kinematics in knees after single versus multiple radius femoral prostheses total knee arthroplasty: a retrospective study

Huang

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Design modifications in prostheses may cause alterations in gait kinematics, thus influencing functional restoration of knees after total knee arthroplasty (TKA). The aim of the study was to investigate the differences in gait kinematics and clinical outcomes after single radius (SR) versus multiple radius (MR) TKA. Method The present retrospective study included 38 unilateral TKA involving 20 knees using MR design implant and 18 knees using SR design implant. Thirty-six healthy volunteers were also recruited. The mean follow-up time was 16 ± 3 months. At the end of follow-up, the 6 degrees of freedom (DOF) kinematics of knees and range of motion (ROM) were measured with a portable optical tracking system. Knee society score (KSS) and knee injury, and osteoarthritis outcome score (KOOS) were also collected. Results Patients in the SR group had significantly higher scores in activities of daily living (84.7 ± 15.9) and sports and recreation (67.5 ± 25.2) KOOS sub-score than MR group (69.9 ± 17.6, P = 0.012; 50.0 ± 20.8, P = 0.027, respectively). Significant differences were detected between MR knees and SR knees (1.82° ± 3.11° vs 4.93° ± 3.58°, P = 0.009), and MR knees and healthy knees (1.82° ± 3.11° vs 3.62° ± 3.52°, P = 0.032) in adduction/abduction ROM. The proximal/distal translation was significantly smaller in MR knees (0.58 ± 0.54 cm) compared with SR knees (1.03 ± 0.53 cm, P = 0.003) or healthy knees (0.84 ± 0.45 cm, P = 0.039). SR knees (0.24 ± 0.40 cm) had smaller translation compared with the MR group (0.54 ± 0.33 cm, P = 0.017) and control group (0.67 ± 0.36 cm, P = 0.028). No significant difference was detected in the other DOFs during the gait cycle. Significant difference was detected in extension/flexion, internal/external rotation, adduction/abduction, proximal/distal and medial/lateral among MR, SR and healthy knees. Conclusion After TKA, patients have altered gait kinematics compared with the control group. MR and SR design showed varied characteristics in 6 DOF gait kinematics, which could be the cause of the difference in functional outcome.

show abstract

Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

Cited by 3 publications

References 41 publications

The effect of total knee geometries on kinematics: An experimental study using a crouching machine

The effect of total knee geometries on kinematics: An experimental study using a crouching machine

Medial‐pivot design does not provide superior clinical results compared to posterior‐stabilized total knee arthroplasty despite kinematic differences during step‐up and lunge activities: A prospective randomized controlled trial under medial tight soft tissue balance

Alterations of kinematics in knees after single versus multiple radius femoral prostheses total knee arthroplasty: a retrospective study

Contact Info

Product

Resources

About