Stair Climbing and High Knee Flexion Activities in Bi-Cruciate Retaining Total Knee Arthroplasty: In Vivo Kinematics and Articular Contact Analysis
| Autor: | Young-Min Kwon, Shuai An, Christian Klemt, Paul Arauz, Sakkadech Limmahakhun |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases Knee Joint Rotation Knee flexion Total knee arthroplasty Kinematics Condyle Weight-Bearing 03 medical and health sciences 0302 clinical medicine Humans Medicine Knee Orthopedics and Sports Medicine Femur Range of Motion Articular Arthroplasty Replacement Knee Aged Orthodontics 030222 orthopedics business.industry Stair climbing Middle Aged In vivo kinematics musculoskeletal system Cruciate retaining Stair Climbing Biomechanical Phenomena Articular contact Fluoroscopy Female Posterior Cruciate Ligament Knee Prosthesis Tomography X-Ray Computed business |
| Zdroj: | The Journal of Arthroplasty. 34:570-576 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2018.11.013 |
| Popis: | Bi-cruciate retaining (BCR) total knee arthroplasty (TKA) preserves both anterior and posterior cruciate ligaments with the potential to restore normal posterior femoral rollback and joint kinematics. However, there is limited information regarding articular contact behavior in the contemporary BCR TKA design during high knee flexion activities. This study aimed to investigate the articular knee contact performance in unilateral BCR TKA patients during strenuous flexion activities.Twenty-nine unilateral BCR TKA patients were evaluated for both knees during single deep lunges, step-ups, and sit-to-stand (STS) using a validated combined computer tomography and dual fluoroscopic imaging system. Medial and lateral condylar contact positions were quantified during weight-bearing flexion.Contact excursions of the lateral condyle in BCR TKAs were significantly more anteriorly located than the contralateral non-operated knees during STS (-4.9 ± 3.1 vs -9.7 ± 4.6 mm, P.05), single deep lunge (-5.7 ± 3.2 vs -10.0 ± 4.5 mm, P.05), and step-ups (-4.8 ± 3.6 vs -9.1 ± 3.9 mm, P.05). Contact points of BCR TKAs indicated reduced femoral external rotation during STS (2.1 ± 4.8° vs 7.7 ± 5.4°, P.05), single deep lunges (1.8 ± 4.8° vs 7.0 ± 7.1°, P.05), and step-ups (0.1 ± 4.1° vs 6.2 ± 4.9°, P .05). Medial pivoting patterns were observed in only 59%, 56%, and 48% of the BCR TKA knees for step-ups, STS, and single deep lunge, respectively.The contemporary BCR TKA design demonstrated asymmetric femoral rollback, medial translation, as well as lateral pivoting in about half of the patient cohort, suggesting that in vivo tibiofemoral kinematic parameters were not fully restored in BCR patients during strenuous flexion activities. |
| Databáze: | OpenAIRE |
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