Cruciate Retaining Implant With Biomimetic Articular Surface to Reproduce Activity Dependent Kinematics of the Normal Knee.

Alterations in normal knee kinematics following total knee arthroplasty (TKA) arise in part from the non-anatomic articular geometry of contemporary implants. In this study, the kinematics of a novel posterior cruciate-retaining (CR) implant with anatomic (biomimetic) articular surface, were compared to that of contemporary CR implants during various simulated activities. Across different simulated activities the biomimetic-CR mimicked normal kinematic patterns more closely than contemporary CR implants. In particular, during deep knee bend and chair-sit, the biomimetic-CR showed medial pivot motion, while other CR implants showed abnormal motion including lateral pivot or no pivot, and paradoxical anterior sliding. Further in vivo and clinical studies are needed to determine whether such biomimetic implants can truly help to achieve a more normal feeling knee and improved patient satisfaction.

[1]  P. Rowe,et al.  A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components. , 2008, The Journal of bone and joint surgery. British volume.

[2]  G. Cerulli,et al.  Patellar pain and incongruence. I: Measurements of incongruence. , 1983, Clinical orthopaedics and related research.

[3]  Wear, delamination, and fatigue resistance of melt‐annealed highly crosslinked UHMWPE cruciate‐retaining knee inserts under activities of daily living , 2010, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[4]  Guoan Li,et al.  Reverse Engineering Nature to Design Biomimetic Total Knee Implants , 2015, The Journal of Knee Surgery.

[5]  Thomas P Andriacchi,et al.  The knee joint center of rotation is predominantly on the lateral side during normal walking. , 2008, Journal of biomechanics.

[6]  Daisuke Takahashi,et al.  Intraoperative medial pivot affects deep knee flexion angle and patient-reported outcomes after total knee arthroplasty. , 2014, The Journal of arthroplasty.

[7]  S. Banks,et al.  In vivo knee kinematics in patients with bilateral total knee arthroplasty of 2 designs. , 2011, The Journal of arthroplasty.

[8]  John L. Williams,et al.  Using Multibody Dynamics to Design Total Knee Replacement Implants , 2013 .

[9]  J. Scarvell,et al.  Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs. , 2011, The Journal of bone and joint surgery. British volume.

[10]  Fang Liu,et al.  Kinematics of medial osteoarthritic knees before and after posterior cruciate ligament retaining total knee arthroplasty , 2011, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[11]  L. Livingston,et al.  The quadriceps angle: a review of the literature. , 1998, The Journal of orthopaedic and sports physical therapy.

[12]  A. Essner,et al.  Knee bearing technology: where is technology taking us? , 2007, The Journal of arthroplasty.

[13]  S. Woo,et al.  Tensile properties of the human femur-anterior cruciate ligament-tibia complex , 1991, The American journal of sports medicine.

[14]  W. Walsh,et al.  Midterm results using a medial pivot total knee replacement compared with the Australian National Joint Replacement Registry data , 2014, ANZ journal of surgery.

[15]  Jörg Lützner,et al.  Patients with no functional improvement after total knee arthroplasty show different kinematics , 2012, International Orthopaedics.

[16]  Harry E Rubash,et al.  Kinematic characteristics of the tibiofemoral joint during a step-up activity. , 2013, Gait & posture.

[17]  V Pinskerova,et al.  The movement of the normal tibio-femoral joint. , 2005, Journal of biomechanics.

[18]  A. Greenwald,et al.  The influence of contemporary knee design on high flexion: a kinematic comparison with the normal knee. , 2008, The Journal of bone and joint surgery. American volume.

[19]  J David Blaha,et al.  The rationale for a total knee implant that confers anteroposterior stability throughout range of motion. , 2004, The Journal of arthroplasty.

[20]  J L Lewis,et al.  The effect of knee-prosthesis geometry on cruciate ligament mechanics during flexion. , 1982, The Journal of bone and joint surgery. American volume.

[21]  D. Schroeder,et al.  Does vitamin E-stabilized ultrahigh-molecular-weight polyethylene address concerns of cross-linked polyethylene in total knee arthroplasty? , 2012, The Journal of arthroplasty.

[22]  Fang Liu,et al.  Tibiofemoral kinematics and condylar motion during the stance phase of gait. , 2009, Journal of biomechanics.

[23]  Shantanu Patil,et al.  Can normal knee kinematics be restored with unicompartmental knee replacement? , 2005, The Journal of bone and joint surgery. American volume.

[24]  G. Cerulli,et al.  Patellar Pain and Incongruence , 1983 .

[25]  Scott L Delp,et al.  Intraoperative passive kinematics of osteoarthritic knees before and after total knee arthroplasty , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

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

[27]  O. Muratoglu,et al.  Knee simulator wear of vitamin E stabilized irradiated ultrahigh molecular weight polyethylene. , 2012, The Journal of arthroplasty.

[28]  J B Stiehl,et al.  The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. , 2000, The Journal of arthroplasty.

[29]  R. Benner,et al.  How Does TKA Kinematics Vary With Transverse Plane Alignment Changes in a Contemporary Implant? , 2012, Clinical orthopaedics and related research.

[30]  D. Dennis,et al.  In Vivo Fluoroscopic Analysis of the Normal Human Knee , 2003, Clinical orthopaedics and related research.

[31]  D. Dennis,et al.  In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate-retaining total knee arthroplasty. , 2002, The Journal of arthroplasty.

[32]  Philip C Noble,et al.  Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? , 2011, The Journal of arthroplasty.

[33]  A. Adili,et al.  Patient perspective survey of total hip vs total knee arthroplasty surgery. , 2012, The Journal of arthroplasty.

[34]  James R. Robinson,et al.  Structural properties of the medial collateral ligament complex of the human knee. , 2005, Journal of biomechanics.

[35]  James Laney Williams,et al.  Total knee arthroplasty kinematics may be assessed using computer modeling: a feasibility study. , 2012, Orthopedics.

[36]  Satoshi Hamai,et al.  Dynamic activity dependence of in vivo normal knee kinematics , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[37]  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.

[38]  A. Williams,et al.  Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using 'interventional' MRI. , 2005, Journal of biomechanics.

[39]  Todd Johnson,et al.  Can in vitro systems capture the characteristic differences between the flexion-extension kinematics of the healthy and TKA knee? , 2009, Medical engineering & physics.

[40]  J. Insall,et al.  Chondromalacia Patellae. A prospective study. , 1976, The Journal of bone and joint surgery. American volume.

[41]  J. Pritchett Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. , 2011, The Journal of arthroplasty.

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

[43]  Scott A. Rodeo,et al.  The Basic Science of Human Knee Menisci , 2012, Sports health.

[44]  A. Amis,et al.  Biomechanics of the menisci of the knee , 2008 .