In Vivo Kinematic Analysis of Total Knee Arthroplasty with Four Different Polyethylene Designs

Abstract

The femorotibial contact point on the sagittal plane was measured under weight-bearing conditions in 45 subjects with implanted and nonimplanted knees. They consisted of 11 knees with flat bearing inserts, 16 knees with shallow dished inserts, 10 knees with posterior lipped inserts, 10 knees with posterior stabilized bearing inserts, and 8 normal knees selected as controls. The average amount of anterior translation of the knee with a flat bearing insert was significantly larger than that of the other implanted knees. The average femorotibial contact point did not differ significantly among knees with shallow dished, posterior lipped, and posterior stabilized bearing inserts, but posterior stabilized knees exhibited most frequently a normal posterior movement. Based on our results, it may be safer to use more anteroposterior constrained bearing inserts in total knee arthroplasty, particularly when the posterior cruciate ligament is loose.

Sagittal plane kinematics of fixed- and mobile-bearing total knee replacements

“…Indeed, many studies have shown a paradoxical slide‐forward of the tibiofemoral contact point with increasing flexion and enormous interindividual differences in the kinematic pattern, especially in posterior cruciate retaining prostheses. [1–3, 8–10, 15–17, 25, 31, 39, 40, 43, 44]. This pattern was found in fixed‐ and mobile‐bearing prostheses.…”

“…This pattern was found in fixed‐ and mobile‐bearing prostheses. Only posterior stabilized prostheses had less variations in deep flexion and during gait [2, 8, 10, 16, 17, 31, 32, 35, 43, 44].…”

Approximation of the functional kinematics of posterior stabilised total knee replacements using a two-dimensional sagittal plane patello-femoral model: comparing model approximation toin vivomeasurement

“…Studies examining the kinematic performance of PS TKR designs (Wada et al 2001;Banks and Hodge 2004;Haas et al 2002;Kanekasu et al 2004;Argenson et al 2005;Yamazaki et al 2005) report observing femoral rollback. Fantozzi et al (2006) correlated significantly higher clinical and functional scores with a more posterior condylar position.…”

The anterior–posterior laxity after total knee arthroplasty inserted with a ligament tensor

“…The ligament tension and geometry of the polyethylene insert may influence the AP laxity with less tension of the ligaments creating more AP laxity [14]. A more dished insert means more congruency with the femoral component, leading to less AP laxity in the knee.…”