Comparison of stability and kinematics of the natural knee versus a PS TKA with a ‘third condyle’

Zaffagnini, Stefano; Bignozzi, S.; Saffarini, Mo; Colle, Francesca; Sharma, Bharat; Kinov, Plamen; Marcacci, Maurilio; Dejour, David

doi:10.1007/s00167-014-3016-3

Cited by 24 publications

(20 citation statements)

References 44 publications

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“…In particular, internal rotation occurs at 0-30 • flexion by screw home rotation of the knee, which we have identified as internal moment. Additionally consistent with our findings, Zaggagnini et al [40], Wunschel et al [41], and Akbari et al [42] showed that tendencies of the anterior, medial translation, and internal rotation directions were similar in knee joints that had undergone TKA and did not exhibit VM impairment when compared with those of the native knee joint. However, the current study confirmed that the valgus moment generally occurred in knee joints that had undergone TKA, in contrast to the findings of previous studies [38,41,43,44].…”

Section: Discussionsupporting

confidence: 93%

Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

et al. 2021

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Four pairs of fresh-frozen cadaver knees (eight knees, four male knees) with a mean age of 72 ± 7 years were used for tests involving a customized simulator capable of controlling quadriceps loading conditions. The muscle force distribution of the quadriceps for the normal loading condition was applied on the basis of muscle cross-sectional area data, as previously reported (VM: 31 N; RF/VI: 49 N; VL: 45 N). To simulate vastus medialis (VM) impairment, we set the muscle force for VM in the muscle force distribution of the quadriceps at zero (VM: 0 N; RF/VI: 49 N; VL: 45 N). The joint reaction forces and moments on knee joints that underwent total knee arthroplasty (TKA) did not differ significantly according to VM impairment status for all flexion angles (p > 0.05). Nevertheless, the vectors of internal–external moments mostly showed a tendency for alteration from external to internal due to VM impairment. This tendency was evident in 9 cases in 12 total test pairs (with and without VM impairment). Furthermore, the vectors of the anterior–posterior reaction forces mostly showed a tendency to increase anteriorly due to VM impairment. This tendency was also evident in 9 cases in 12 total test pairs (with and without VM impairment). These results indicate that posterior dislocation of the tibia may be induced if VM impairment occurs after TKA. In conclusion, VM impairment in knee joints undergoing TKA may contribute to posterior dislocation of the tibia by a paradoxical roll-back with enhancements of the anterior joint reaction force and external moment during knee-joint flexion. Our findings may be valuable for understanding the mechanism of potential instability and malfunction due to VM impairment in knee joints after TKA, and may help to optimize clinical/rehabilitation training plans to improve the prognosis (stability and function) of knee joints undergoing TKA.

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Section: Discussionsupporting

confidence: 93%

Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

et al. 2021

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“…With these navigation systems, data on varus-valgus and rotational profiles can be obtained during TKA surgery. Such intraoperative kinematic data might provide instructive clinical information for the refinement of surgical techniques, as well as information on the anticipated postoperative clinical outcomes [2,3,8,9,14,15,[18][19][20]25]. In addition, it is possible that the subjective medical examination in clinical practice could be performed objectively by using navigation.…”

Section: Introductionmentioning

confidence: 99%

Navigation-based tibial rotation at 90° of flexion is associated with better range of motion in navigated total knee arthroplasty

Ishida

Shibanuma

Matsumoto

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Laxity and functional kinematics have been published in both the intact and implanted knee [ 1 , 5 , 8 , 9 , 12 , 14 , 15 , 24 , 25 , 35 ]; however, the effect of downsizing the femoral component and polyethylene insert on the knee’s laxity envelope is not well reported. Surgeons strive to restore function and feel of the unimplanted, healthy knee by matching native boney and soft tissue anatomy with the TKA component options available [ 19 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Femoral and tibial insert downsizing increases the laxity envelope in TKA

Mueller¹,

Wentorf²,

Moore³

2014

Knee Surg Sports Traumatol Arthrosc

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PurposeThis study examines the effect of component downsizing in a modern total knee arthroplasty (TKA) system on the laxity envelope of the knee throughout flexion.MethodsA robotic testing system was utilized to measure laxity envelopes in the implanted knee by in the anterior–posterior (AP), medial–lateral (ML), internal–external (IE) and varus–valgus (VV) directions. Five fresh-frozen cadavers were tested with a modern cruciate retaining TKA implantation, a 1-mm thinner polyethylene insert and a femoral component 2 mm smaller in the AP dimension.ResultsThe downsized tibial insert was more lax throughout the flexion arc with up to 2.0 mm more laxity in the AP direction at full extension, a 43.8 % increase over the original implantation. A thinner insert consistently increased laxity throughout the arc of flexion in all degrees of freedom. Downsizing the femoral component resulted in 8.5 mm increase in AP laxity at 90°, a 73.9 % increase. In mid-flexion, downsizing the femur produced similar laxity values to the downsized insert in AP, ML, IE and VV directions.ConclusionDownsizing the TKA components had significant effects on laxity throughout flexion. Downsizing a femoral component 2 mm had an equivalent increase in laxity in mid-flexion as downsizing the tibial insert 1 mm. This study quantifies the importance of choosing the appropriate implant component size, having the appropriate size available and the effect of downsizing. The laxity of the implanted knee contributes to how the implant feels to the patient and ultimately the patient’s satisfaction with their new knee.

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Comparison of stability and kinematics of the natural knee versus a PS TKA with a ‘third condyle’

Cited by 24 publications

References 44 publications

Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

Navigation-based tibial rotation at 90° of flexion is associated with better range of motion in navigated total knee arthroplasty

Femoral and tibial insert downsizing increases the laxity envelope in TKA

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