Muscle loaded stability reflects ligament-based stability in TKA: a cadaveric study
| Autor: | Jan Victor, Nele Arnout, Johan Bellemans, Matthias Verstraete, Amélie Chevalier |
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| Rok vydání: | 2020 |
| Předmět: |
Joint Instability
musculoskeletal diseases medicine.medical_specialty Knee Joint Kinematics 03 medical and health sciences 0302 clinical medicine Cadaver medicine Humans Orthopedics and Sports Medicine Femur Range of Motion Articular Arthroplasty Replacement Knee Orthodontics 030222 orthopedics Ligaments biology business.industry Muscles Biomechanics 030229 sport sciences musculoskeletal system biology.organism_classification Biomechanical Phenomena Valgus medicine.anatomical_structure Orthopedic surgery Ligament Surgery Implant Cadaveric spasm business |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 30:612-620 |
| ISSN: | 1433-7347 0942-2056 |
| Popis: | This paper aims at evaluating the effects of muscle load on knee kinematics and stability after TKA and second at evaluating the effect of TKA surgery on knee kinematics and stability; and third, at correlating the stability in passive conditions and the stability in active, muscle loaded conditions. Fourteen fresh frozen cadaveric knee specimens were tested under passive and active condition with and without external loads involving a varus/valgus and internal/external rotational torque before and after TKA surgery using two in-house developed and previously validated test setups. Introduction of muscle force resulted in increased valgus (0.98°) and internal rotation of the femur (4.64°). TKA surgery also affected the neutral path kinematics, resulting in more varus (1.25°) and external rotation of the femur (5.22°). All laxities were significantly reduced by the introduction of the muscle load and after implantation of the TKA. The presence of the implant significantly affects the active varus/valgus laxity. This contrasts with the rotational laxity, in which case the passive laxity is the main determinant for the active laxity. For the varus/valgus laxity, the passive laxity is also a significant predictor of the active laxity. Knee stability is clearly affected by the presence of muscle load. This points to the relevance of appropriate rehabilitation with focus on avoiding muscular atrophy. At the same time, the functional, muscle loaded stability strongly relates to the passive, ligament-based stability. It remains therefore important to assess knee stability at the time of surgery, since the passive laxity is the only predictor for functional stability in the operating theatre. Case series, Level IV. |
| Databáze: | OpenAIRE |
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