Quantitative, Comparative Assessment of Gait Between Single-Radius and Multi-Radius Total Knee Arthroplasty Designs

Larsen, Bethany; Jacofsky, Marc C.; Jacofsky, David J.

doi:10.1016/j.arth.2015.01.014

Cited by 29 publications

(44 citation statements)

References 28 publications

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“…Wang et al [12] reported that a prolonged duration was required in patients undergoing the MR design to perform the sit-to-stand test than those undergoing the SR design as assessed by 3-dimensional kinematics. Larsen et al [17] and Kim et al [19] reported higher extensor strength in SR knees than that in their MR counterparts. Although SR protheses showed better results in [21] conducted an isokinetic study and observed better extensor performance with decreased flexion peak torque and increased extension peak torque in patients with SR design than those with MR design.…”

Section: Discussionmentioning

confidence: 94%

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Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Zhang

et al. 2020

Arthroplasty

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Background: Strength deficits, muscle imbalances, and quadriceps inhibition are common after the total knee arthroplasty (TKA). It was suggested that theoretically single radius (SR) femoral protheses could provide longer extensor moment arm compared to the multiple radius (MR) design. However, quantitative evidence has not yet been reported. Thus, the aim of the study was to investigate the differences in isokinetic data and to compare the patient-reported outcome scores between TKA SR and MR design. Method: The present retrospective study included 36 TKA involving 16 knees (9 patients) using SR design implant and 20 knees (11 patients) using MR design implant. The mean follow-up time was longer than 1 year. Isokinetic knee flexion and extension torques of the operated leg were evaluated at 60°/s and 180°/s. Quadriceps and hamstring torques and ratios, work and power were recorded. Angle-specific torques were also collected at different extension or flexion angles. Results: Both groups showed improvement in knee society scores (KSS) and knee injury, and osteoarthritis outcome score (KOOS) after operation. Patients in SR group had significantly higher scores in KSS-knee, symptoms and activities of daily living KOOS sub-score than those in the MR group at the end of the follow-up. The peak knee flexion torque, peak knee extension torque and maximum knee flexion work were greater in SR group at 180°/s and 60°/s. At 60°/s, and SR group had higher average knee flexion power and average knee extension power than MR group. In the isometric contraction test, the knee extension torque was higher in SR group than in MR group. At 180°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°compared with MR group. At 60°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°, 80°when compared with MR group. Additionally, SR group also provided higher extension torques at 40°, 50°, 60°than the MR group. There were no differences in other isokinetic and isometric parameters between the two groups. Conclusion: Femoral design exerted an influence on quadriceps and hamstring strength after TKA, and SR design shows advantages, in terms of higher extension and flexion strength, over MR design.

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Section: Discussionmentioning

confidence: 94%

“…Clinical studies that compared the SR and MR femoral design yielded contradictory results [14][15][16][17][18][19]. Liu et al conducted a meta-analysis in order to find the difference in clinical outcomes between the SR and MR femoral design.…”

Section: Introductionmentioning

confidence: 99%

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Zhang

et al. 2020

Arthroplasty

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“…11,12 Additionally, research in our laboratory found that the SR TKA design more closely replicates normal walking of agematched controls than the MR design. 5 MR TKA patients had decreased knee flexion, extensor moment, and power absorption compared with age-matched controls during level walking. In contrast, there were no significant differences between 1-year postoperative SR TKAs and agematched controls in any biomechanical parameters.…”

mentioning

confidence: 85%

“…4 However, several other studies found no difference between SR and MR knees for patient-reported outcomes. [5][6][7] As the knee undergoes flexion in the MR knee, the radius of curvature decreases, shortening the moment arm of the hamstrings and quadriceps. Therefore, in comparison to SR TKA patients, MR TKA patients will produce a lower moment for the same force production (moment ¼ force Â distance) at more flexed knee angles.…”

mentioning

confidence: 99%

Comparison of Knee Kinematics and Kinetics during Stair Ascent in Single-Radius and Multiradius Total Knee Arthroplasty

et al. 2018

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Traditionally total knee arthroplasty (TKA) design has been based on theories of the movement of the healthy knee joint. Currently, there are two competing theories on the flexion/extension axis of rotation of the knee with disparate radii of rotation, and thus differing movement patterns. The purpose of our study was to compare stair ascent kinematics and kinetics of single-radius (SR) and multiradius (MR) TKA subjects. We hypothesized that the knee kinematics and kinetics of SR TKA patients would more closely replicate healthy age matched controls during stair ascent than MR TKA patients, 1 year after TKA. Both patient groups had large improvements in biomechanical and clinical outcome measures following surgical intervention. However, the SR knee design performs closer to healthy controls than MR knees during stair ascent, supporting results that have been previously obtained for level walking. SR TKA subjects demonstrated reduced power production and sagittal moment compared with controls, albeit more than MR TKA subjects. This study demonstrates that patients who receive SR TKA have kinematics more closely aligned to normal patterns postoperatively than those who received an MR TKA. The power production and sagittal moment of the healthy controls most closely match previously published values of younger adults, SR TKA group most closely matches older adults, while the MR TKA group has lower power production and sagittal moments than either previously published age group. This strongly suggests that the biomechanical differences found in this study are evidence of functional deficiencies. Further research is needed to determine how these deficiencies progress with patient aging.

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“…1 Gait analysis has also shown that SR-TKA implant outperformed the MR-TKA implant in terms of matching the biomechanical properties of the prosthetic knee to that of a healthy control. 3 However, Liu et al showed in their meta-analysis that these biomechanical differences do not appear to translate to any difference in clinical outcomes. 4 Nonetheless, many of these studies originate from Western nations.…”

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confidence: 99%

Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians

et al. 2018

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Single-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's -test and Mann-Whitney U-test. Logistic regression model was used to evaluate the odds of SR-TKA or MR-TKA achieving the minimum clinically important difference (MCID) of studied outcomes. Patients in both groups had similar age (65.7 ± 7.6 vs. 65.8 ± 8.2 years; = 0.317), gender proportion (71% females vs. 79% females; = 0.119), and ethnic distribution (80% Chinese vs. 84% Chinese; = 0.258). Preoperatively, there were no statistically significant differences between both groups for ROM, Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form (SF)-36 scores. At 2 years, all outcomes were statistically similar or failed to achieve a difference of MCID. Controlling for all preoperative variables, SR-TKA has significantly lower odds of achieving MCID for OKS (odds ratio [OR]: 0.275, 95% confidence interval [CI]: 0.114-0.663; = 0.004) and SF-36 Physical Component Summary (PCS) (OR: 0.547; 95% CI: 0.316-0.946; = 0.031) compared with MR-TKA. In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS.

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Quantitative, Comparative Assessment of Gait Between Single-Radius and Multi-Radius Total Knee Arthroplasty Designs

Cited by 29 publications

References 28 publications

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Comparison of Knee Kinematics and Kinetics during Stair Ascent in Single-Radius and Multiradius Total Knee Arthroplasty

Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians

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