No Differences Identified in Transverse Plane Biomechanics Between Medial Pivot and Rotating Platform Total Knee Implant Designs

Papagiannis, Georgios; Roumpelakis, Ilias M.; Triantafyllou, Athanasios; Makris, Ioannis; Babis, George C.

doi:10.1016/j.arth.2016.01.050

Cited by 26 publications

(29 citation statements)

References 28 publications

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“…In this regard, mobile-bearing TKA and UKA aim to improve survivorship rates providing more natural tibial internal rotation and reducing contact stresses compared with fixed-bearing implants by means of rotating platforms [45,46]. Nevertheless, mobile-bearing KA still remains controversial in terms of enhanced survivorship and more natural kinematics, essentially complicating the question to what extent the rotational behavior of the knee influences the lifespan of KA [47,48]. …”

Section: Discussionmentioning

confidence: 99%

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

et al. 2016

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After knee arthroplasty (KA) surgery, patients experience abnormal kinematics and kinetics during numerous activities of daily living. Biomechanical investigations have focused primarily on level walking, whereas walking on sloped surfaces, which is stated to affect knee kinematics and kinetics considerably, has been neglected to this day. This study aimed to analyze over-ground walking on level and sloped surfaces with a special focus on transverse and frontal plane knee kinematics and kinetics in patients with KA. A three-dimensional (3D) motion analysis was performed by means of optoelectronic stereophogrammetry 1.8 ± 0.4 years following total knee arthroplasty (TKA) and unicompartmental arthroplasty surgery (UKA). AnyBody™ Modeling System was used to conduct inverse dynamics. The TKA group negotiated the decline walking task with reduced peak knee internal rotation angles compared with a healthy control group (CG). First-peak knee adduction moments were diminished by 27% (TKA group) and 22% (UKA group) compared with the CG during decline walking. No significant differences were detected between the TKA and UKA groups, regardless of the locomotion task. Decline walking exposed apparently more abnormal knee frontal and transverse plane adjustments in KA patients than level walking compared with the CG. Hence, walking on sloped surfaces should be included in further motion analysis studies investigating KA patients in order to detect potential deficits that might be not obvious during level walking.

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Section: Discussionmentioning

confidence: 99%

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

et al. 2016

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“…The long-term efficacy of TKA is determined by recovery of normal kinematic function of the knees [2], [3]. Prosthesis selection for optimising joint geometry can result in better long-term recovery of joint kinematic function [4]. The latest national study by Liu Q demonstrated that the number of elderly osteoarthritis patients and patients living with knee dysfunction are increasing in China, along with various associated burdens [5].…”

Section: Introductionmentioning

confidence: 99%

Does mobile-bearing have better flexion and axial rotation than fixed-bearing in total knee arthroplasty? A randomised controlled study based on gait

Zeng

Yan

et al. 2020

Journal of Orthopaedic Translation

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ObjectiveTo analyse the 6 degrees of freedom of the knee and gait data of patients with medial knee osteoarthritis before and after fixed-bearing (FB) and mobile-bearing (MB) total knee arthroplasty (TKA) and examine the influence of TKA on gait characteristics and the difference between FB and MB prosthesis. We also sought to explore the prosthesis options available for TKA in these patients.MethodsThirty patients who underwent TKA at the Department of Orthopedics at our hospital from June to October 2017 were included. All patients had a lower limb mechanical axis (hip-knee-ankle angle) of less than 180° which were regarded as genu varum knees and had medial knee osteoarthritis. Patients were randomised divided into the FB group and the MB group according to the knee prosthesis implanted. An infrared navigation three-dimensional portable knee motion analysis system (Opti-Knee®, Shanghai Innomotion, Inc.) was used to acquire data on the 6 degrees of freedom of both knees when walking on flat ground before and after surgery (angle of tibia relative to femur parameters: flexion-extension, internal rotation–external rotation, abduction–adduction; displacement parameters: anterior–posterior, proximal–distal, medial–lateral). Postoperative follow-up efficacy was assessed using the Oxford Knee Score system.ResultsThere were significant differences in the maximum values of the internal/external rotation and flexion/extension angle between patients post-TKA and the healthy population, p values were 0.007 and <0.001,respectively. The postoperative maximum values of genu varum and internal rotation in both FB [(−9.49 ± 5.99°), (−5.77 ± 3.42°), respectively] and MB [(−9.64 ± 4.83°), (−7.54 ± 4.51°), respectively] groups were lower than the preoperative ones [FB (−15.13 ± 6.78°), (−8.28 ± 4.83°); MB (−13.28 ± 3.98°), (−9.46 ± 4.99°), respectively] (p ≤ 0.001), while the postoperative maximum values of flexion angle and anterior displacement in both FB [(46.11 ± 4.14°), (0.71 ± 0.35 cm), respectively] and MB [(49.33 ± 3.98°), (0.75 ± 0.89 cm), respectively] groups were larger than the preoperative ones [FB (43.15 ± 3.77°), (0.26 ± 0.74 cm); MB (44.62 ± 5.92°), (0.33 ± 0.79°), respectively] (p ≤ 0.001). The postoperative range of flexion/extension angle in both FB (40.13 ± 4.14°) and MB (45.82 ± 3.76°) groups was significantly larger than the preoperative one [FB (36.17 ± 6.07°), MB (37.09 ± 3.93°), respectively] (p ≤ 0.001). There were also significant increases in range of anterior–posterior displacement in the FB group (0.85 ± 0.32 cm) postoperatively compared with the preoperative one (0.71 ± 0.92 cm) (p = 0.016) and significant increases in range of medial-lateral displacement (0.64 ± 0.73 cm) in the MB group postoperatively compared with the preoperative one (0.52 ± 0.91 cm) (p = 0.025). The mean flexion/extension angle of the MB group was significantly greater than the FB group after surgery in both the stance phase and the swing phase (p < 0.001). Th...

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“…Similar to our and Bae et al 's studies, 13) the RCT done by Hossain et al 5) found improvement in patient performance in terms of activities of daily living and high-performance activities like sports and exercises were significantly better in the MP group than in the PS knee. According to Papagiannis et al 's kinematic and kinetic analysis, 21) early outcomes could not demonstrate any notable functional and wear advantages between the two groups. Likewise, Benjamin et al 's study 20) revealed comparable functional grades for both PS and MP groups.…”

Section: Discussionmentioning

confidence: 91%

“…As far as MP total knee arthroplasty is concerned, there are limited studies comparing its outcomes with those of other implant designs (Table 3). 5,13,[18][19][20][21][22][23][24][25] To date, there is only one randomized study by Hossain et al, 5) which has compared outcomes of an MP knee to a fixed-bearing multi-radius PS implant. There are three other randomized controlled trials (RCTs), which have compared an MP design to a mobile PS knee: an ultra-congruent rotating platform knee in studies by Kim et al 18) and Kim et al 19) and a single radius knee in a study by Benjamin et al 20) There are a few more matched pair studies and case series, which have looked at outcomes of the MP design.…”

Section: Discussionmentioning

confidence: 99%

“…The FJS was similar in both groups as in the study by Kim et al 18) Contrary to our findings, Hossain et al 5) in their RCT and Samy et al 22) in their matched pair study found better WOMAC score and FJS score in MP knees as compared to PS knees. Various studies 13,20,21,23) found no difference in patient-reported outcome measures (PROM) when they compared an MP knee to other designs. It seems that knee flexion was the prime determinant in deciding final PROM scores, and hence the PROM scores favored devices that facilitated better flexion in a patient.…”

Section: Discussionmentioning

confidence: 99%

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Early Outcomes of Medial Pivot Total Knee Arthroplasty Compared to Posterior-Stabilized Design: A Randomized Controlled Trial

Kulshrestha

Sood

Kanade³

et al. 2020

Clin Orthop Surg

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The overwhelming success of total knee arthroplasty (TKA) has rapidly increased its utilization. 1,2) Initially, the procedure was largely meant to relieve pain and preserve mobility in the elderly, but it has expanding the spectrum of usage to include a younger, demanding population. Its significant effect on improving quality of life has made enormous socioeconomic impact. To optimize outcomes of TKA, there have been rapid advances in each aspect of the surgery, including preoperative patient optimization, precise surgical technique, effective pain control, and expeditious rehabilitation. 2) Even with these changes, 10%−15% of patients remain dissatisfied. 3) One of the reasons for dissatisfaction is presumed to be altered kinemat

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No Differences Identified in Transverse Plane Biomechanics Between Medial Pivot and Rotating Platform Total Knee Implant Designs

Cited by 26 publications

References 28 publications

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

Does mobile-bearing have better flexion and axial rotation than fixed-bearing in total knee arthroplasty? A randomised controlled study based on gait

Early Outcomes of Medial Pivot Total Knee Arthroplasty Compared to Posterior-Stabilized Design: A Randomized Controlled Trial

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