Videofluoroscopic Evaluation of the Influence of a Gradually Reducing Femoral Radius on Joint Kinematics During Daily Activities in Total Knee Arthroplasty.

Autor: List R; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Human Performance Lab, Schulthess Clinic, Zurich, Switzerland., Schütz P; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Angst M; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Ellenberger L; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Dätwyler K; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland., Ferguson SJ; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2020 Oct; Vol. 35 (10), pp. 3010-3030. Date of Electronic Publication: 2020 May 27.
DOI: 10.1016/j.arth.2020.05.039
Abstrakt: Background: Paradoxical anterior translation in midflexion is reduced in total knee arthroplasties (TKAs) with a gradually reducing femoral radius, when compared to a 2-radii design. This reduction has been shown in finite element model simulations, in vitro tests, intraoperatively, and recently also in vivo during a lunge and unloaded flexion-extension. However, TKA kinematics are task dependent and this reduction has not been tested for gait activities.
Methods: Thirty good outcome subjects (≥1 year postoperatively) with a unilateral cruciate-retaining TKA with a gradually reducing (n = 15) or dual (n = 15) femoral radius design were assessed during 5 complete cycles of level walking, stair descent (0.18-m steps), deep knee bend, and sitting down onto and standing up from a chair, using a moving fluoroscope (25 Hz, 1 ms shutter time). Kinematic data were extracted by 2D/3D image registration.
Results: Tibiofemoral ranges of motion for flexion-extension, abduction-adduction, internal-external rotation, and anteroposterior (AP) translation were similar for both groups, whereas the pattern of AP translation-flexion-coupling differed. The subjects with the dual-radii design showed a sudden change in direction of AP translation around 30° of flexion, which was not present in the subjects with the gradually reducing femoral radius design.
Conclusion: Through the unique ability of moving fluoroscopy, the present study confirmed that the gradually reducing femoral radii eliminated the paradoxical sudden anterior translation at 30° present in the dual-radii design in vivo during daily activities, including gait and stair descent.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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