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Knee kinematics are not different between asymmetrical and symmetrical tibial baseplates in total knee arthroplasty: A fluoroscopic analysis of step-up and lunge motions.
Koster, Lennard A; Kaptein, Bart L; van der Linden-van der Zwaag, Enrike H M J; Nelissen, Rob G H H.
Afiliación
  • Koster LA; Department of Orthopaedics, Biomechanics and Imaging Group, Leiden University Medical Center, Leiden, The Netherlands.
  • Kaptein BL; Department of Orthopaedics, Biomechanics and Imaging Group, Leiden University Medical Center, Leiden, The Netherlands.
  • van der Linden-van der Zwaag EHMJ; Department of Orthopaedics, Biomechanics and Imaging Group, Leiden University Medical Center, Leiden, The Netherlands.
  • Nelissen RGHH; Department of Orthopaedics, Biomechanics and Imaging Group, Leiden University Medical Center, Leiden, The Netherlands.
Knee Surg Sports Traumatol Arthrosc ; 32(5): 1253-1263, 2024 May.
Article en En | MEDLINE | ID: mdl-38488225
ABSTRACT

PURPOSE:

This clinical fluoroscopy study investigated knee kinematics of two different cemented fixed-bearing, posterior-stabilised (PS) total knee arthroplasty (TKA) designs an asymmetric tibial component including an asymmetric insert designed to optimise personalised balance and fit and its precursor symmetrical design with symmetric insert.

METHODS:

A consecutive series of patients (16 TKAs from each treatment group) participating in a randomised controlled trial comparing TKA migration was included. The exclusion criterion was the use of walking aids. Flat-panel fluoroscopic recordings of step-up and lunge motions were acquired 1-year postoperatively. Medial and lateral contact points (CPs) were determined to calculate CP displacement, femoral axial rotation and pivot position. Using linear mixed-effects modelling techniques, kinematics between TKA designs were compared.

RESULTS:

During knee extension between 20° flexion and full extension, the CPs moved anteriorly combined with a small internal femoral rotation (a screw-home mechanism). Whereas CP movement was reversed femoral rollback, external femoral rotation while flexing the knee between full extension and 20° knee flexion, At larger flexion angles, femoral axial rotation (FAR) occurred around a lateral pivot point both during step-up and lunge. The symmetric design had a 2.3° larger range of FAR compared to the asymmetric design during lunge (p = 0.02). All other kinematics were comparable.

CONCLUSION:

Despite the differences in design, this study showed that the asymmetric and symmetric PS TKA designs had mostly comparable knee kinematics during step-up and lunge motions. It is therefore expected that the functionality of the successor TKA design is similar to that of its precursor design. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Tibia / Rango del Movimiento Articular / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Tibia / Rango del Movimiento Articular / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania