In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy
| Autor: | T Grieco, Richard D. Komistek, Adrija Sharma, G Dessinger, Harold E. Cates |
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| Rok vydání: | 2018 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Knee Joint Rotation Anterior cruciate ligament Total knee arthroplasty Kinematics Prosthesis Design Weight-Bearing 03 medical and health sciences Femoral rollback 0302 clinical medicine Humans Medicine Fluoroscopy Orthopedics and Sports Medicine Femur Anterior Cruciate Ligament Range of Motion Articular Arthroplasty Replacement Knee Aged Orthodontics 030222 orthopedics medicine.diagnostic_test business.industry 030229 sport sciences Middle Aged musculoskeletal system Single surgeon Biomechanical Phenomena Surgery medicine.anatomical_structure Posterior cruciate ligament Female Posterior Cruciate Ligament Knee Prosthesis business |
| Zdroj: | The Journal of Arthroplasty. 33:565-571 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2017.09.035 |
| Popis: | Background The bicruciate stabilized (BCS) total knee arthroplasty (TKA) features asymmetrical bearing geometry and dual substitution for the anterior cruciate ligament and posterior cruciate ligament (PCL). Previous TKA designs have not fully replicated normal knee motion, and they are characterized by lower magnitudes of overall rollback and axial rotation than the normal knee. Methods In vivo kinematics were derived for 10 normal knees and 40-second generation BCS TKAs all implanted by a single surgeon. Mobile fluoroscopy and three-dimensional-to-two-dimensional registration was used to analyze anterior-posterior motion of the femoral condyles and femorotibial axial rotation during weight-bearing flexion. Statistical analysis was conducted at the 95% confidence level. Results From 0° to 30° of knee flexion, the BCS subjects exhibited similar patterns of femoral rollback and axial rotation compared to normal knee subjects. From 30° to 60° of knee flexion, BCS subjects experienced negligible anterior-posterior motions and axial rotation while normal knees continued to rollback and externally rotate. Between 60° and 90° the BCS resumed posterior motion and, after 90°, axial rotation increased in a normal-like fashion. Conclusion Similarities in early flexion kinematics suggest that the anterior cam-post is supporting normal-like anterior-posterior motion in the BCS subjects. Likewise, lateral femoral rollback and external rotation of the femur in later flexion provides evidence for appropriate substitution of the PCL via the posterior cam-post. Being discrete in nature, the dual cam-post mechanism does not lend itself to adequate substitution of the cruciate ligaments in mid-flexion during which anterior cruciate ligament tension is decreasing and PCL tension is increasing in the normal knee. |
| Databáze: | OpenAIRE |
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