In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion

Tsai, Tsung‐Yuan; Li, Jingsheng; Rubash, Harry E.; Li, Guoan; Freiberg, Andrew A.

doi:10.1016/j.clinbiomech.2015.12.006

Cited by 30 publications

(23 citation statements)

References 35 publications

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“…Following TKA, the effect of embalming on the contact mechanics would be reduced because the meniscus and cartilage is removed and replaced with the prosthesis as we examined the postoperative contact mechanics with different PTS, rather than the differences before and after surgery. The medial condyle translated posteriorly during knee flexion and reached a maximum of 13.5 mm at 120° of flexion, and the lateral condyle translated more posteriorly than the medial condyle and reached a maximum of 27.7 mm at 120° of flexion in this study, which is very close to the results (about 15 mm and 27.5 mm) from Feng’s in vivo knee kinematics study [ 37 ]. The postoperative knee kinematics from this study is also similar to that from Steinbrück’s study in which PS-TKA was performed on fresh-frozen knee specimens [ 12 ].…”

Section: Discussionsupporting

confidence: 89%

The biomechanical effect of different posterior tibial slopes on the tibiofemoral joint after posterior-stabilized total knee arthroplasty

2020

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Background Different posterior tibial slopes (PTS) after posterior-stabilized total knee arthroplasty (PS-TKA) may lead to different biomechanical characteristics of knee joint. This cadaveric study was designed to investigate the tibiofemoral kinematics and contact pressures after PS-TKA with different PTS. Methods Nine human cadaveric knee specimens were used for PS-TKA with the PTS of 3°, 6°, and 9°. The tibiofemoral kinematics and contact pressures were measured during knee flexion angle changing from 0 to 120° (with an increment of 10°) with an axial load of 1000 N at each angle. Results The root mean square (RMS) of the tibiofemoral contact area and the mean and peak contact pressures during knee flexion were 586.2 mm 2 , 1.85 MPa, and 5.39 MPa before TKA and changed to 130.2 mm 2 , 7.56 MPa, and 17.98 MPa after TKA, respectively. Larger contact area and smaller mean and peak contact pressures were found in the joints with the larger PTS after TKA. The RMS differences of femoral rotation before and after TKA were more than 9.9°. The posterior translation of the lateral condyle with larger PTS was more than that with smaller PTS, while overall, the RMS differences before and after TKA were more than 11.4 mm. Conclusion After TKA, the tibiofemoral contact area is reduced, and the contact pressure is increased greatly. Approximately 80% of the femoral rotation is lost, and only about 60% of the femoral translation of lateral condyle is recovered. TKA with larger PTS results in more posterior femoral translation, larger contact area, and smaller contact pressure, indicating that with caution, it may be beneficial to properly increase PTS for PS-TKA.

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Section: Discussionsupporting

confidence: 89%

The biomechanical effect of different posterior tibial slopes on the tibiofemoral joint after posterior-stabilized total knee arthroplasty

2020

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“…Previously, predicted mechanics of the intact tibiofemoral joint agreed with cadaveric measurements obtained in a robotic simulator including anterior translation and internal rotation (≤0.4 mm and 1.6° root mean square (RMS) error, respectively) and collateral and cruciate ligament forces (≤5.7 N RMS error) from full extension to 130° of flexion . Extending this previous work, we compared the predicted AP translations of the medial and lateral femoral condyles with respect to the tibia with corresponding data from a cadaveric experiment, since these outcome measures are a common means of describing tibiofemoral kinematics in knee arthroplasty applications . The medial and lateral condyles were respectively represented by tracking the most prominent peaks on the medial and lateral sides of the femur (i.e., the femoral epicondyles) as has been previously utilized (Fig.…”

Section: Methodsmentioning

confidence: 60%

“…The medial and lateral condyles were respectively represented by tracking the most prominent peaks on the medial and lateral sides of the femur (i.e., the femoral epicondyles) as has been previously utilized (Fig. B) . The AP translations of these points were determined relative to an AP‐oriented vector.…”

Section: Methodsmentioning

confidence: 99%

Fixed‐bearing medial unicompartmental knee arthroplasty restores neither the medial pivoting behavior nor the ligament forces of the intact knee in passive flexion

Kia

Warth

Lipman

et al. 2018

Journal Orthopaedic Research

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Medial unicompartmental knee arthroplasty (UKA) is an accepted treatment for isolated medial osteoarthritis. However, using an improper thickness for the tibial component may contribute to early failure of the prosthesis or disease progression in the unreplaced lateral compartment. Little is known of the effect of insert thickness on both knee kinematics and ligament forces. Therefore, a computational model of the tibiofemoral joint was used to determine how non-conforming, fixed bearing medial UKA affects tibiofemoral kinematics, and tension in the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL) during passive knee flexion. Fixed bearing medial UKA could not maintain the medial pivoting that occurred in the intact knee from 0° to 30° of passive flexion. Abnormal anterior-posterior (AP) translations of the femoral condyles relative to the tibia delayed coupled internal tibial rotation, which occurred in the intact knee from 0° to 30° of flexion, but occurred from 30° to 90° of flexion following UKA. Increasing or decreasing tibial insert thickness following medial UKA also failed to restore the medial pivoting behavior of the intact knee despite modulating MCL and ACL forces. Reduced AP constraint in non-conforming medial UKA relative to the intact knee leads to abnormal condylar translations regardless of insert thickness even with intact cruciate and collateral ligaments. This finding suggests that the conformity of the medial compartment as driven by the medial meniscus and articular morphology plays an important role in controlling AP condylar translations in the intact tibiofemoral joint during passive flexion. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1868-1875, 2018.

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“…A good outcome in total knee arthroplasty (TKA) depends on many factors, including joint alignment, range of motion, patellar tracking, and ligament stability. It is now generally recognized that knee axes are used for both component alignment in knee arthroplasty Feng, Tsai et al [1] and ideal placement of the prosthesis during knee reconstructive surgery Kim, Chung et al [2]. Consequently, estimating of the knee axis is one of the key topics for the "2010 ASME Grand Challenge Competition to Predict in Vivo Knee Loads" Fregly, Besier et al [3].…”

Section: Introductionmentioning

confidence: 99%

Topological Space of the Knee Tensegrity System

Kim¹

2018

BJSTR

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Estimating the knee axis is crucial to both correctly aligning components in knee arthroplasty and assessing the joint kinematics. From the point of view of perceptual psychology, it is especially interesting that one can use the part-whole relationship at the knee joint as the basic theory. We characterize the concept of a "knee axis" and further the concept of "surrounding." It is now generally recognized that the whole-part relationship, and the relationships of the parts to each other play a fundamental role in producing the screw axis of the knee (SAK). We present conditions of component alignment in the arthroplasty based on the principle that the part should become a member of the whole. If any screw motion with respect to the SAK is applied to the lines of forces that form the surrounding, these forces remain within the surroundung.

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In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion

Cited by 30 publications

References 35 publications

The biomechanical effect of different posterior tibial slopes on the tibiofemoral joint after posterior-stabilized total knee arthroplasty

The biomechanical effect of different posterior tibial slopes on the tibiofemoral joint after posterior-stabilized total knee arthroplasty

Fixed‐bearing medial unicompartmental knee arthroplasty restores neither the medial pivoting behavior nor the ligament forces of the intact knee in passive flexion

Topological Space of the Knee Tensegrity System

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