Kinematic comparison between asymmetrical and symmetrical polyethylene inserts during deep knee bend activity

Nakamura, Shinichiro; Kuriyama, Shinichi; Ito, Hiromu; Nishitani, Kohei; Song, Young Dong; Ikebe, Satoru; Higaki, Hidehiko; Matsuda, Shinya

doi:10.1016/j.jos.2021.04.001

Cited by 2 publications

(2 citation statements)

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“…Nakamura et al showed that TKA with asymmetrical inserts may be kinematically superior to symmetrical inserts due to the greater axial rotation; this could explain the rotational differences between the XP and the AS inserts. 19 Regarding the anteroposterior translation of the femur, the AS insert was associated with the smallest anterior translation at maximum extension. Paradoxical femoral anterior translation occurs during the early stage of knee flexion after TKA 20,21 and is caused due to the combination of extensor mechanism mechanics and the absence of the ACL.…”

Section: Discussionmentioning

confidence: 96%

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Intraoperative Kinematics in Posterior Cruciate Ligament Retaining Total Knee Arthroplasty Using Different Inserts

Sumida,

Fujimoto,

Masuda

et al. 2024

J Knee Surg

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We analyzed the intraoperative kinematics of total knee arthroplasty (TKA) using a navigation system to investigate the influence of different inserts on kinematics. This was a retrospective observational study. The Vanguard individualized design (ID) (33 patients, 33 knees) XP and anterior-stabilized (AS) inserts were used in TKA for osteoarthritis. Kinematic data were intraoperatively recorded. The range of motion, tibiofemoral rotational angle, anteroposterior translation of the femur, and varus-valgus laxity were compared between the two inserts (XP vs AS). There was no significant difference in the range of motion (extension: XP, 3.7° ± 3.3° vs AS, 3.8° ±3.3°, p=0.84; flexion: XP, 138.1° ± 10.2° vs AS, 139.0° ±13.3°, p=0.73). With the AS insert, the tibia was gradually internally rotated as the knee was flexed. At maximum extension, the internal rotation was smallest with AS (XP 6.5°±4.0° vs. AS 5.1°±3.4°, p=0.022), which was also associated with smaller anterior femoral translation (maximum extension: XP, 14.1 mm ± 4.8 mm vs AS, 11.3 mm ± 4.7 mm, p=0.00036; 30°: XP, 23.7 mm ± 5.6 mm vs AS, 20.7 mm ± 5.1 mm, p=0.000033; 45°: XP, 24.4mm ± 4.9mm vs AS, 23.2mm ± 4.5mm, p=0.0038). The AS was associated with a lower varus-valgus laxity (30° XP 4.1°±3.4 vs AS 3.3°±2.7°, p=0.036; 60°: XP, 3.2°±3.0° vs AS, 2.4°±3.3°, p=0.0089). The AS insert facilitated sequential tibiofemoral rotation with varus-valgus stability in mid-flexion without restricting the range of motion.

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Section: Discussionmentioning

confidence: 96%

“…These results indicate the importance of medial stability in the screw-home movement. Nakamura et al showed that TKA with asymmetrical inserts may be kinematically superior to symmetrical inserts due to the greater axial rotation; this could explain the rotational differences between the XP and the AS inserts 19 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%