In Vivo Comparison of Knee Kinematics for Subjects Having Either a Posterior Stabilized or Cruciate Retaining High-Flexion Total Knee Arthroplasty

Cates, Harold E.; Komistek, Richard D.; Mahfouz, Mohamed R.; Schmidt, Monica A.; Anderle, Matthew R.

doi:10.1016/j.arth.2007.09.019

Cited by 92 publications

(59 citation statements)

References 35 publications

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“…This pattern in our study was similar to the results reported by Casino et al [3], which may have been due to transection of the anterior cruciate ligament (ACL) during TKA. We also noted that posterior translation of the femur up to 30°of knee flexion after TKA was not so much during the passive flexion, which is consistent with findings in the previous kinematic studies of TKA under weight-bearing conditions [3,4,6,20,27]. However, the average amount of posterior femoral roll back in the preoperative knees was maintained after TKA in our study (P=0.14).…”

Section: Discussionsupporting

confidence: 82%

“…This dissatisfaction may be explained partly by abnormal kinematics following TKA [1], and thus, knee kinematics following TKA have been studied extensively [4,6,7,12,17,[22][23][24][25]27]. Although preoperative knee conditions, prosthesis design, and surgical technique are generally believed to influence the knee kinematics following TKA, kinematic studies have primarily focussed on postoperative knee kinematics [4,6,7,17,[22][23][24][25]27].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs

Seon

Park

Jeong

et al. 2010

International Orthopaedics (SICOT)

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The authors evaluated the relationships between preoperative and postoperative kinematics in 50 osteoarthritic knees scheduled for cruciate retaining total knee arthroplasty with regards to posterior femoral roll back and external femoral rotation using a navigation system from 10°to 120°of knee flexion. Although posterior femoral roll back was maintained, external femoral rotation was significantly decreased compared to those of the preoperative knee after total knee arthroplasty. However, the amount of posterior roll back and external femoral rotation after total knee arthroplasty were found to be significantly positively related to those measured preoperatively (r=0.62 and 0.57, respectively). These significant kinematic correlations may explain why preoperative range of knee motion influences range of motion after total knee arthroplasty.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs

Seon

Park

Jeong

et al. 2010

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

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“…PFR was also more consistent with relevant values in normal knees 29 than that reported recently. 30,31 These data support the efficacy of the BCS TKA design, which incorporates an asymmetric spinecam mechanism and dissimilar conformity at the lateral and medial compartments. In our study, no paradoxical AP motion was observed in any patients during any of the tasks.…”

Section: Kinematics Of Bi-cruciate Substituting Tkasupporting

confidence: 58%

In vivo kinematics and kinetics of a bi‐cruciate substituting total knee arthroplasty: A combined fluoroscopic and gait analysis study

Catani

Ensini

Belvedere

et al. 2009

Journal Orthopaedic Research

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After total knee arthroplasty, changes in articular surface geometry, soft tissue treatment, and component alignment can alter normal lower limb function. The guided motion bi-cruciate substituting prosthesis was designed specifically to restore physiological knee joint motion. We determined whether this design could in vivo normal kinematics and kinetics, not only at the replaced knee, but also throughout both lower limbs. Sixteen patients (4 male, 12 female, mean age of 68.2 years with a range from 58 to 79 years) with primary knee osteoarthritis were implanted with the bi-cruciate substituting prosthesis. At 6-month follow-up, knee joint kinematics was assessed by video-fluoroscopy during stair-climbing, chair-rising/sitting, and step-up/down. Lower limb overall function was also assessed on the same day by standard gait analysis with simultaneous electromyography during level walking. By video-fluoroscopy, mean anteroposterior translations between femoral and tibial components during the three motor tasks were 9.7 AE 3.0, 10 AE 2.6, and 6.9 AE 3.5 mm on the medial compartment, and 14.3 AE 3.5, 18.5 AE 3.0, and 13.9 AE 3.8 mm on the lateral compartment, respectively. Axial rotation ranged from 5.68 to 26.28. Gait analysis revealed restoration of nearly normal walking patterns in most patients. This rare combination of measurements, i.e., accurate rotation-translation at the replaced knee and complete locomotion patterns at both lower limb joints, suggested that bi-cruciate substituting arthroplasty can restore physiological knee motion and normal overall function. ß

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“…There is no common definition of condylar liftoff, which is diversely described as being between 0.75 and two millimetres [7,12]. Also, different measuring techniques from the distance of the lowest point of the medial and lateral condyle to the closest point on the tibial polyethylene insert or to the tibial plateau are described [7,9,12]. Condylar liftoff, however, does not correlate with pain or instability [14] but is supposed to improve functional performance [12].…”

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)

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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.

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In Vivo Comparison of Knee Kinematics for Subjects Having Either a Posterior Stabilized or Cruciate Retaining High-Flexion Total Knee Arthroplasty

Cited by 92 publications

References 35 publications

Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs

Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs

In vivo kinematics and kinetics of a bi‐cruciate substituting total knee arthroplasty: A combined fluoroscopic and gait analysis study

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

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