In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties

Banks, Scott; Markovich, G D; Hodge, W. Andrew

doi:10.1016/s0883-5403(97)90026-7

Cited by 285 publications

(164 citation statements)

References 18 publications

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“…In contrast to the normal knee, in vivo kinematic analyses suggest subjects undergoing TKA often experience a motion pattern opposite the normal knee where the condyles slide in the anterior direction with increasing knee flexion [2,8,9,24,28,31,[34][35][36][37]. Also, in vivo kinematic studies involving patients undergoing TKA have documented reverse rotational patterns [2,10] and lateral condylar liftoff [13,21,34,37]. There is evidence these abnormal kinematic patterns lead to decreased ROM [3,11,38].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Kinematics after a Cruciate-substituting TKA

Victor

Mueller

Komistek

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Threedimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was À14.0 mm and À23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8°. The average weightbearing range of motion (ROM) was 1098 (range, 608-1508; standard deviation, 18.78). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design.

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Section: Introductionmentioning

confidence: 99%

In Vivo Kinematics after a Cruciate-substituting TKA

Victor

Mueller

Komistek

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…normal screw-home mechanism) [8,10,15,16]. Previous total knee arthroplasty (TKA) studies have been limited and have analysed small numbers of patients, often using nonweight-bearing conditions or only throughout a limited percentage of the entire flexion range [1,2,7,11,12,18,19]. It is assumed that different axial rotation magnitudes and patterns (i.e.…”

Section: Introductionmentioning

confidence: 99%

Comparison of tibial rotation in fixed and mobile bearing total knee arthroplasty using computer navigation

Stiehl

2008

International Orthopaedics (SICOT)

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Tibial rotation is an important aspect of knee function and can be altered after total knee arthroplasty (TKA). These alterations include decreased internal rotation with knee flexion as compared to the normal state and paradoxical external rotation with flexion. Mobile bearing total knee prostheses may allow greater unconstrained tibial rotation. I compared tibial rotation after fixed bearing or mobile bearing total knee arthroplasty in 82 patients who underwent TKA with the tibia cut first technique to ascertain any differences. Using intraoperative imageless computer navigation, measurements included the determination of tibial rotation from extension to 90°flexion before and after prosthetic implantation with non-weight-bearing range of motion. I found that tibial rotation was significantly reduced after fixed bearing total knee replacement as compared to mobile bearing. In addition, the tibial position compared to the distal femur in extension was more external in fixed bearings compared to mobile bearings. Placing the fixed tibial tray with increased internal rotation could explain this difference.Résumé La rotation du tibia est un élément important sur le plan fonctionnel. Elle peut être altérée après une prothèse totale du genou. Ces altérations de la rotation portent sur une diminution de la rotation interne et paradoxalement une augmentation de la rotation externe en flexion. Une prothèse totale du genou à plateau mobile permet une libération plus importante de la rotation tibiale. Nous avons comparé cette rotation à partir de prothèses à la plateau fixe et à plateau mobile sur une série de 82 patients ayant bénéficie de cette arthroplastie avec une coupe première du tibia. Nous avons utilisé pour cela un système de navigation per opératoire. Nous avons trouvé à l'issue de cette étude que les rotations tibiales étaient significativement réduites après prothèse totale à plateau fixe versus prothèses à plateau mobile. Par ailleurs, la position du tibia en extension est en rotation externe par rapport au fémur distal. Cette rotation est plus importante dans les prothèses à plateau fixe que dans les prothèses à plateau mobile. Le positionnement du plateau tibial en rotation interne lors de l'intervention peut expliquer cette différence.

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“…However, in the step up and down task, knee flexion was always smaller than 658. 8,9 Therefore, to compare in vivo performance of CR and PS designs, ADL motor tasks that involve considerable joint load and higher knee flexion angles should be investigated.…”

Section: Introductionmentioning

confidence: 99%

Femoral rollback of cruciate-retaining and posterior-stabilized total knee replacements: In vivo fluoroscopic analysis during activities of daily living

et al. 2006

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Restoration of the physiological flexor/extensor mechanism at the knee in terms of appropriate muscular lever arms, proper required quadriceps force, and suitable patellofemoral compressive force, is fundamental for the success of total knee replacement. Therefore, measurements of anteroposterior translation of the femoral component over the tibial base-plate against joint flexion during daily living activities are essential for the assessment of the in vivo performance of current prosthesis designs. Patients treated with posterior stabilized and cruciate retaining prostheses with excellent clinical scores were evaluated during stair climbing, sitting and rising from a chair, and step up and down, using a three-dimensional pose reconstruction technique based on videofluoroscopy. The posterior stabilized patients experienced a fairly consistent and physiological rollback specific of each motor task, demonstrating proper function of the spine-cam mechanism. Rollback was somehow inconsistent among subjects in the cruciate retaining group, accompanied with a smaller range of knee flexion. In this group, more posterior locations of the condyles correlated significantly with higher clinical and functional scores. Articular surface conformity restores physiological rollback in the presence of a spine-cam mechanism, but not coherently in the presence of the posterior cruciate ligament. ß

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In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties

Cited by 285 publications

References 18 publications

In Vivo Kinematics after a Cruciate-substituting TKA

In Vivo Kinematics after a Cruciate-substituting TKA

Comparison of tibial rotation in fixed and mobile bearing total knee arthroplasty using computer navigation

Femoral rollback of cruciate-retaining and posterior-stabilized total knee replacements: In vivo fluoroscopic analysis during activities of daily living

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