Patient-specific design for articular surface conformity to preserve normal knee mechanics in posterior stabilized total knee arthroplasty

Autor:	Sae Kwang Kwon, Juhyun Son, Oh-Ryong Kwon, Kyoung-Tak Kang, Yong-Gon Koh
Rok vydání:	2018
Předmět:	Adult Male musculoskeletal diseases Knee Joint Biomedical Engineering Total knee arthroplasty Kinematics Prosthesis Design Biomaterials Cruciate ligament 03 medical and health sciences 0302 clinical medicine medicine Humans Computer Simulation Knee Range of Motion Articular Arthroplasty Replacement Knee Orthodontics 030222 orthopedics business.industry Biomechanics Posterior stabilized 030229 sport sciences General Medicine Patient specific Articular surface musculoskeletal system surgical procedures operative medicine.anatomical_structure Ligament Knee Prosthesis business
Zdroj:	Bio-Medical Materials and Engineering. 29:401-414
ISSN:	1878-3619 0959-2989
DOI:	10.3233/bme-180998
Popis:	Background Contemporary total knee arthroplasty (TKA) provides remarkable clinical benefits. However, the normal function of the knee is not fully restored. Recent improvements in imaging and manufacturing have utilized the development of customized design to fit the unique shape of individual patients. Objective The purpose of the present study is to investigate the preservation of normal knee biomechanics by using specific articular surface conformity in customized posterior stabilized (PS)-TKA. Methods This includes customized PS-TKA, PS-TKA with conforming conformity (CPS-TKA), medial pivot conformity with PS-TKA (MPS-TKA), and PS-TKA with mimetic anatomy femoral and tibial articular surface (APS-TKA). In this study, kinematics, collateral ligament force and quadriceps force were evaluated using a computational simulation under a deep knee bend condition. Results A conventional TKA did not provide the normal internal tibial rotation with flexion leading to abnormal femoral rollback. The APS-TKA exhibited normal-like femoral rollback kinematics but did not exhibit normal internal tibial rotation. However, APS-TKA exhibited the most normal-like collateral ligament and quadriceps forces. Conclusions Although the APS-TKA exhibited more normal-like biomechanics, it did not restore normal knee biomechanics owing to the absence of the cruciate ligament and post-cam mechanism.
Databáze:	OpenAIRE
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