Comparison of the in-vivo kinematics of three different knee prosthesis designs during a step-up movement

Rehman, Yasser; Koster, Lennard A; Röhrl, Stephan M; Aamodt, Arild

doi:10.1016/j.clinbiomech.2022.105824

Cited by 2 publications

(7 citation statements)

References 35 publications

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“…In addition, the medial-CP ROM was larger than the lateral-CP ROM resulting in femoral rotations around a lateral pivot point. This is contrary to previous studies showing larger lateral-CP displacement compared to medial-CP displacement, resulting in FAR around a medial pivot point [6,9,40,42]. Most studies, including this current study, showed comparable TKA kinematics between 0°a nd approximately 20-30°flexion.…”

Section: Discussioncontrasting

confidence: 99%

“…The observed kinematics (femoral rollback/roll forward and FARs between extension and 20° flexion) in this study are comparable, although different in magnitude, to those reported by other studies assessing the kinematics of PS TKAs [10, 13, 40]. In this study, considerable paradoxical anterior and posterior medial‐CP displacement were observed during lunge and step‐up with knee flexion angles > 20°.…”

Section: Discussioncontrasting

confidence: 99%

“…Although studies showed that medial pivot designs do indeed result in medial pivot points during motion [40, 43], considerable variability was reported in lateral‐CP displacement for medial pivot designs [43], and knee balancing was shown to be more important than insert geometry [45].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies, including this current study, showed comparable TKA kinematics between 0° and approximately 20–30° flexion. The kinematic differences appear to become more pronounced at larger knee flexion, which could be due to the differences in motions studied, that is, sit to stand [42], the height of the riser platform [40] or the actual insert geometry varying not only between types [42] (medial‐congruent, ultracongruent, PS etc.) but between manufacturers as well.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple asymmetric (anatomically shaped) tibial components with asymmetric inserts have been introduced, aiming for a better anatomical fit and closer to native knee kinematics. However, knee kinematic studies of anatomic TKA designs showed considerable heterogeneity in kinematics [6,7,40,43]. It is, therefore, essential to use objective measurements to test new TKA designs not only for initial fixation using radiostereometric analysis (RSA) [33] but also for function and kinematics.…”

Section: Introductionmentioning

confidence: 99%

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Knee kinematics are not different between asymmetrical and symmetrical tibial baseplates in total knee arthroplasty: A fluoroscopic analysis of step‐up and lunge motions

Koster,

Kaptein,

van der Linden‐van der Zwaag

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThis clinical fluoroscopy study investigated knee kinematics of two different cemented fixed‐bearing, posterior‐stabilised (PS) total knee arthroplasty (TKA) designs: an asymmetric tibial component including an asymmetric insert designed to optimise personalised balance and fit and its precursor symmetrical design with symmetric insert.MethodsA consecutive series of patients (16 TKAs from each treatment group) participating in a randomised controlled trial comparing TKA migration was included. The exclusion criterion was the use of walking aids. Flat‐panel fluoroscopic recordings of step‐up and lunge motions were acquired 1‐year postoperatively. Medial and lateral contact points (CPs) were determined to calculate CP displacement, femoral axial rotation and pivot position. Using linear mixed‐effects modelling techniques, kinematics between TKA designs were compared.ResultsDuring knee extension between 20° flexion and full extension, the CPs moved anteriorly combined with a small internal femoral rotation (a screw‐home mechanism). Whereas CP movement was reversed: femoral rollback, external femoral rotation while flexing the knee between full extension and 20° knee flexion, At larger flexion angles, femoral axial rotation (FAR) occurred around a lateral pivot point both during step‐up and lunge. The symmetric design had a 2.3° larger range of FAR compared to the asymmetric design during lunge (p = 0.02). All other kinematics were comparable.ConclusionDespite the differences in design, this study showed that the asymmetric and symmetric PS TKA designs had mostly comparable knee kinematics during step‐up and lunge motions. It is therefore expected that the functionality of the successor TKA design is similar to that of its precursor design.Level of EvidenceLevel II, prospective comparative study.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Knee kinematics are not different between asymmetrical and symmetrical tibial baseplates in total knee arthroplasty: A fluoroscopic analysis of step‐up and lunge motions

Koster,

Kaptein,

van der Linden‐van der Zwaag

et al. 2024

Knee surg. sports traumatol. arthrosc.

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No difference in patient-reported outcomes with cruciate-retaining, anterior-stabilized, and posterior-stabilized total knee arthroplasty designs

Rehman,

Korsvold,

Lerdal

et al. 2023

Bone Joint J

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AimsThis study compared patient-reported outcomes of three total knee arthroplasty (TKA) designs from one manufacturer: one cruciate-retaining (CR) design, and two cruciate-sacrificing designs, anterior-stabilized (AS) and posterior-stabilized (PS).MethodsPatients scheduled for primary TKA were included in a single-centre, prospective, three-armed, blinded randomized trial (n = 216; 72 per group). After intraoperative confirmation of posterior cruciate ligament (PCL) integrity, patients were randomly allocated to receive a CR, AS, or PS design from the same TKA system. Insertion of an AS or PS design required PCL resection. The primary outcome was the mean score of all five subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS) at two-year follow-up. Secondary outcomes included all KOOS subscales, Oxford Knee Score, EuroQol five-dimension health questionnaire, EuroQol visual analogue scale, range of motion (ROM), and willingness to undergo the operation again. Patient satisfaction was also assessed.ResultsPatients reported similar levels of pain, function, satisfaction, and general health regardless of the prosthetic design they received. Mean maximal flexion (129° (95% confidence interval (CI) 127° to 131°) was greater in the PS group than in the CR (120° (95% CI 121° to 124°)) and AS groups (122° (95% CI 120° to 124°)).ConclusionDespite differences in design and constraint, CR, AS, and PS designs from a single TKA system resulted in no differences in patient-reported outcomes at two-year follow-up. PS patients had statistically better ROM, but the clinical significance of this finding is unclear.Cite this article: Bone Joint J 2023;105-B(12):1271–1278.

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Comparison of the in-vivo kinematics of three different knee prosthesis designs during a step-up movement

Cited by 2 publications

References 35 publications

Knee kinematics are not different between asymmetrical and symmetrical tibial baseplates in total knee arthroplasty: A fluoroscopic analysis of step‐up and lunge motions

Knee kinematics are not different between asymmetrical and symmetrical tibial baseplates in total knee arthroplasty: A fluoroscopic analysis of step‐up and lunge motions

No difference in patient-reported outcomes with cruciate-retaining, anterior-stabilized, and posterior-stabilized total knee arthroplasty designs

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