In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate–retaining total knee arthroplasty

Bertin, Kim C; Komistek, Richard D.; Dennis, Douglas A.; Hoff, William; Anderson, Dylan T.; Langer, Todd

doi:10.1054/arth.2002.35793

Cited by 80 publications

(61 citation statements)

References 35 publications

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“…Dennis et al [7] observed liftoff in 75% of CR-TKAs and cruciatesubstituting TKAs. Bertin et al [2] reported decreased liftoff laterally, with increased flexion (50% of subjects at 80°and 35% at 100°) and a reduction of lateral liftoff in the medial-pivot TKA: only one of five had liftoff. Whether the general lack of liftoff in our study was the result of the comparison of two different gap-balancing techniques remains unclear and warrants further investigation.…”

Section: Discussionmentioning

confidence: 97%

“…The ease of bending the knee 3 years postoperatively compared to 1 year may be the reason for the different positions. In vivo fluoroscopic studies avoid this problem by selecting the frames in 10°to 30°increments [2,4,5,13,16,17,23,24] at certain flexion angles. Second, our radiographs in flexion were nonweightbearing.…”

Section: Discussionmentioning

confidence: 99%

“…Bertin et al [2] looked at asymmetric femoral components of a CR-TKA during deep-knee bending in 20 patients and observed internal rotation of 1.4°. Only 10 of his 20 patients had internal rotation.…”

Section: Discussionmentioning

confidence: 99%

“…If the difference was greater than 1 mm, liftoff was denoted. Bertin et al [2] used the same technique, but it remained unclear whether both authors measured the distance of the lowest point of the medial and lateral condyles to the closest point on the tibial PE insert or to the tibial plateau. Dennis et al [7] rotated the 3D image of the matched femoral and tibial components to a frontal view and measured the distance of both condyles to the tibial tray.…”

Section: Discussionmentioning

confidence: 99%

“…One medial-pivot TKA design has demonstrated up to 10°tibial internal rotation at 100°flexion and lateral femoral rollback of 7.3 mm [16], which was confirmed by Schmidt et al [21] who measured rollback of 3 mm. One asymmetric CR-TKA design demonstrated tibial internal rotation of 1.4°and lateral rollback [2]. Medial-pivot TKAs have comparable good long-term results [15], but patients prefer this design over others [19,20].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Fitz¹,

Sodha

Reichmann

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Normal knee kinematics is characterized by posterior femorotibial rollback with tibial internal rotation and medial-pivot rotation in flexion. Cruciate-retaining TKAs (CR-TKAs) do not reproduce normal knee kinematics. Questions/purposes We hypothesized a more anatomic reconstruction of the medial femoral condyle, simultaneously preserving the tension of the PCL and medial collateral ligament, resulted in (1) medial-pivot rotation and tibial internal rotation, (2) lateral femoral rollback, and (3) reduced liftoff. Patients and Methods We compared 10 patients who underwent CR-TKA using the new technique at their 1-year followup to a matched control group of nine patients using a traditional gap-balancing technique at their 2-to 4-year followup. All patients received lateral radiographs in extension and flexion, which we utilized for threedimensional implant matching to calculate tibial internal rotation, lateral rollback, and lateral liftoff in extension and flexion. Results The new gap-balancing technique resulted in a median of 3.5°tibial internal rotation with 2.7-mm rollback of the lateral femoral condyle relative to the medial condyle in flexion, which was different from the control group. We found no differences in liftoff between the groups. Conclusions The new technique resulted in tibial internal rotation with flexion and lateral rollback comparing the lateral to the medial condyle in flexion, but no differences in condylar liftoff. These preliminary results were comparable to published kinematic results of an asymmetric CR-TKA or medial-pivot CR-TKA but not to symmetric CR-TKA.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Fitz¹,

Sodha

Reichmann

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

Total Knee Arthroplasty

Lee

Sohn

2000

Musculoskeletal Aspects of Haemophilia

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Kinematic analysis of kneeling in cruciate‐retaining and posterior‐stabilized total knee arthroplasties

Hamai

Miura

Higaki

et al. 2007

Journal Orthopaedic Research

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ABSTRACT:Kneeling is an important function of the knee for many activities of daily living. In this study, we evaluated the in vivo kinematics of kneeling after total knee arthroplasty (TKA) using radiographic based image-matching techniques. Kneeling from 90 to 1208 of knee flexion produced a posterior femoral rollback after both cruciate-retaining and posterior-stabilized TKA. It could be assumed that the posterior cruciate ligament and the post-cam mechanism were functioning. The posterior-stabilized TKA design had contact regions located far posterior on the tibial insert in comparison to the cruciate-retaining TKA. Specifically, the lateral femoral condyle in posteriorstabilized TKA translated to the posterior edge of the tibial surface, although there was no finding of subluxation. After posterior-stabilized TKA, the contact position of the post-cam translated to the posterior medial corner of the post with external rotation of the femoral component. Because edge loading can induce accelerated polyethylene wear, the configuration of the post-cam mechanism should be designed to provide a larger contact area when the femoral component rotates.ß

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In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate–retaining total knee arthroplasty

Cited by 80 publications

References 35 publications

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Total Knee Arthroplasty

Kinematic analysis of kneeling in cruciate‐retaining and posterior‐stabilized total knee arthroplasties

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