In vivo weight-bearing kinematics with medial rotation knee arthroplasty.

Knee arthroplasties are designed to accommodate flexion, axial rotation and anteroposterior (AP) translation. Axial rotation during extension varies, with some rotating platform devices allowing unrestricted rotation while some conforming fixed-bearing designs almost none. The purpose of this study was to examine in vivo kinematics of a fixed-bearing medial rotation-type arthroplasty (MRK) during weight-bearing activities. Fifteen knees with a medial pivot TKA design were studied during step and pivot activities using lateral fluoroscopy and model-image registration. Average knee kinematics during the step activity showed little AP translation or rotation from 0 degrees -100 degrees flexion. During the pivot activity, the mean tibial internal rotation in individual knees was 7 degrees (3 degrees -19 degrees ). Mean condylar translations for individual knees were 3mm medially and 5mm laterally. The medial pivot prosthesis design provides anteroposterior stability during demanding activities, and exhibits a medial pivot motion pattern when subjected to twisting.

[1]  G. Scuderi**,et al.  Survivorship of cemented total knee arthroplasty. , 1997, Clinical orthopaedics and related research.

[2]  J. Stiehl,et al.  Detrimental kinematics of a flat on flat total condylar knee arthroplasty. , 1999, Clinical orthopaedics and related research.

[3]  L. Draganich,et al.  The effects of early rollback in total knee arthroplasty on stair stepping. , 2002, The Journal of arthroplasty.

[4]  Scott A Banks,et al.  Implant Design Affects Knee Arthroplasty Kinematics during Stair-stepping , 2004, Clinical orthopaedics and related research.

[5]  Mohamed R Mahfouz,et al.  A Multicenter Analysis of Axial Femorotibial Rotation after Total Knee Arthroplasty , 2004, Clinical orthopaedics and related research.

[6]  Mohamed R Mahfouz,et al.  Multicenter Determination of In Vivo Kinematics After Total Knee Arthroplasty , 2003, Clinical orthopaedics and related research.

[7]  W. Harper,et al.  A 15-year follow-up study of 4606 primary total knee replacements. , 2007, The Journal of bone and joint surgery. British volume.

[8]  S.A. Banks,et al.  Accurate measurement of three-dimensional knee replacement kinematics using single-plane fluoroscopy , 1996, IEEE Transactions on Biomedical Engineering.

[9]  J David Blaha,et al.  Fluoroscopic Analyses of Cruciate-Retaining and Medial Pivot Knee Implants , 2003, Clinical orthopaedics and related research.

[10]  H Miura,et al.  Contact stress at the post-cam mechanism in posterior-stabilised total knee arthroplasty. , 2005, The Journal of bone and joint surgery. British volume.

[11]  J. Schmieg.  THE EFFECT OF POST IMPINGEMENT IN POSTERIOR STABILIZED TOTAL KNEE REPLACEMENTS ON FEMORAL ROTATION AND DAMAGED AREA AS DETERMINED FROM ANALYSIS OF RETRIEVED TIBIAL INSERTS , 2001 .

[12]  Peter Herberts,et al.  Kinematics of Three Variations of the Freeman-Samuelson Total Knee Prosthesis , 2003, Clinical orthopaedics and related research.

[13]  M. Conditt,et al.  Does Total Knee Replacement Restore Normal Knee Function? , 2005, Clinical orthopaedics and related research.

[14]  M. Bottlang,et al.  A Mobile-bearing Knee Prosthesis Can Reduce Strain at the Proximal Tibia , 2006, Clinical orthopaedics and related research.

[15]  S. Banks,et al.  Observations of Femoral Rollback in Cruciate-Retaining Knee Arthroplasty , 2002, Clinical orthopaedics and related research.

[16]  T P Andriacchi,et al.  Retention of the posterior cruciate in total knee arthroplasty. , 1988, The Journal of arthroplasty.

[17]  J. Pritchett.  Patient preferences in knee prostheses. , 2004, The Journal of bone and joint surgery. British volume.

[18]  Benjamin J. Fregly,et al.  Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements , 2005, Knee Surgery, Sports Traumatology, Arthroscopy.

[19]  L. Dorr,et al.  Rationale of the Knee Society clinical rating system. , 1989, Clinical orthopaedics and related research.

[20]  S. Banks,et al.  2003 Hap Paul Award Paper of the International Society for Technology in Arthroplasty. Design and activity dependence of kinematics in fixed and mobile-bearing knee arthroplasties. , 2004, The Journal of arthroplasty.

[21]  S A Banks,et al.  In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties. , 1997, The Journal of arthroplasty.

[22]  Johan Bellemans,et al.  Physiologic kinematics as a concept for better flexion in TKA. , 2006, Clinical orthopaedics and related research.

[23]  R B Bourne,et al.  Tibial Post Wear in Posterior Stabilized Total Knee Arthroplasty: An Unrecognized Source of Polyethylene Debris , 2001, The Journal of bone and joint surgery. American volume.

[24]  J. Stiehl,et al.  Fluoroscopic analysis of kinematics after posterior-cruciate-retaining knee arthroplasty. , 1995, The Journal of bone and joint surgery. British volume.

[25]  Scott A. Banks,et al.  Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.

[26]  S. J. Tupling,et al.  Use of cardan angles to locate rigid bodies in three-dimensional space , 1987, Medical and Biological Engineering and Computing.

[27]  O. Mahoney,et al.  The effect of total knee arthroplasty design on extensor mechanism function. , 2002, The Journal of arthroplasty.

[28]  T. Andriacchi,et al.  The influence of total knee-replacement design on walking and stair-climbing. , 1982, The Journal of bone and joint surgery. American volume.

[29]  Knee rotation during a weightbearing activity: influence of turning. , 2008, Gait & posture.

[30]  D. Dennis,et al.  In Vivo Kinematics for Fixed and Mobile-Bearing Posterior Stabilized Knee Prostheses , 2004, Clinical orthopaedics and related research.

[31]  PD Dr. Werner Müller,et al.  The Knee , 1982, Springer Berlin Heidelberg.

[32]  Scott Banks,et al.  Tibiofemoral kinematic analysis of kneeling after total knee arthroplasty. , 2004, The Journal of arthroplasty.

[33]  Greta C Bernatz,et al.  Video task analysis of turning during activities of daily living. , 2007, Gait & posture.

[34]  Angelo Cappello,et al.  Fluoroscopic and gait analysis of the functional performance in stair ascent of two total knee replacement designs. , 2003, Gait & posture.

[35]  A. Carr,et al.  Questionnaire on the perceptions of patients about total knee replacement. , 1998, The Journal of bone and joint surgery. British volume.