Virtual reconstruction of the posterior cruciate ligament for mechanical testing of total knee arthroplasty implants.

Autor: Sarpong NO; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, United States of America. Electronic address: nosarp1@gmail.com., Sonnenfeld JJ; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, United States of America., LiArno S; Stryker, 325 Corporate Drive, Mahwah, NJ 07430, United States of America., Rajaravivarma R; Stryker, 325 Corporate Drive, Mahwah, NJ 07430, United States of America., Donde S; Stryker, 325 Corporate Drive, Mahwah, NJ 07430, United States of America., Sneddon E; Stryker, 325 Corporate Drive, Mahwah, NJ 07430, United States of America., Kaverina T; Stryker, 325 Corporate Drive, Mahwah, NJ 07430, United States of America., Cooper HJ; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, United States of America., Shah RP; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, United States of America., Geller JA; Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY 10032, United States of America.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2020 Jan; Vol. 27 (1), pp. 151-156. Date of Electronic Publication: 2019 Nov 21.
DOI: 10.1016/j.knee.2019.10.023
Abstrakt: Background: Total knee arthroplasty (TKA) design continues to be refined. As part of the pre-clinical design process, kinematic evaluation under ideal circumstances must be simulated. Previously, this was accomplished mechanically through the use of elastomeric bumpers and human cadaver models, which can be costly and time-intensive. With improved technology, a six-axis joint simulator now allows for virtual ligament reconstruction. The aim of this study was to create and evaluate a virtual posterior cruciate ligament (PCL) model to simulate native knee kinematics for component testing in TKA.
Methods: Three human cadaveric knee specimens were utilized, each mounted in a six-axis joint simulator and the femoral and tibial ligament insertion points digitized. Ligament stiffness and kinematics were first tested with the intact knee, followed by retesting after PCL transection. Knee kinematic testing was then repeated, and the virtual PCL was reconstructed until it approximated that of the intact knee by achieving less than 10% random mean square (RMS) error.
Results: A virtual three-bundle PCL was created. The RMS error in anterior-posterior motion between the virtually reconstructed PCL and the intact knee ranged from six to eight percent for simulated stair climbing in the three knee specimens tested, all within our target goal of less than 10%.
Conclusion: This study indicated that a virtually reconstructed three-bundle PCL with a joint simulator can replicate knee kinematics. Such an approach is valuable to obtain clinically relevant kinematics when testing cruciate-retaining total knee arthroplasty under force control.
Competing Interests: Declaration of competing interest This project was funded and completed as part of the Stryker Resident and Fellow Research Program.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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