Purpose: Reproducing the femoral rollback through specially designed mechanism in knee implants is required to achieve full knee function in total knee arthroplasty. Most contemporary implants use cam/post mechanism to replace the function of Posterior Cruciate Ligament. This study was aimed to determine the most appropriate cam and post designs to produce normal femoral rollback of the knee.
Methods: Three different cams (triangle, ellipse, and circle) and three different posts (straight, convex, concave) geometries were considered in this study and were analysed using kinematic analyses. Femoral rollback did not occur until reaching 50° of knee flexion. Beyond this angle, two of the nine combinations demonstrate poor knee flexion and were eliminated from the study.
Results: The combination of circle cam with concave post, straight post and convex post showed 15.6, 15.9 and 16.1 mm posterior translation of the femur, respectively. The use of ellipse cam with convex post and straight post demonstrated a 15.3 and 14.9 mm femoral rollback, whilst the combination of triangle cam with convex post and straight post showed 16.1 and 15.8 mm femoral rollback, respectively.
Conclusion: The present study demonstrates that the use of circle cam and convex post created the best femoral rollback effect which in turn produces the highest amount of knee flexion. The findings of the study suggest that if the design is applied for knee implants, superior knee flexion may be possible for future patients.
Level Of Evidence: IV.
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http://dx.doi.org/10.1007/s00167-014-3227-7 | DOI Listing |
Indian J Orthop
January 2025
Department of Orthopaedics, Apollo Hospitals, Greams Road, Chennai, 600006 India.
Background: Ultracongruent (UC) total knee replacement (TKR) designs, serving as alternatives to posterior stabilized (PS) and cruciate retaining (CR) designs, lack conclusive evidence regarding posterior femoral rollback. This study aimed to compare intraoperative posterior femoral rollback and maximal knee flexion between UC and PS inserts, addressing the paucity of literature on femoral rollback achieved with UC designs in total knee replacement.
Methods: A consecutive cohort of 20 patients undergoing robotic-assisted primary total knee replacement, posterior femoral rollback and maximal intraoperative knee flexion were assessed.
J Exp Orthop
October 2024
Department of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan.
Purpose: The efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees.
Methods: The kinematics of 19 valgus knees and 19 varus knees operated in the MP TKA were investigated under fluoroscopy during squatting using a two- to three-dimensional registration technique.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Introduction: This study aimed to compare the differences in the radiological, clinical, and functional outcomes and the estimated restoration rate of native knee alignment between total knee arthroplasty (TKA) with bi-cruciate stabilized (BCS) and posterior stabilized (PS) design.
Materials And Methods: This retrospective study included consecutive patients between 2020 and 2021 who underwent TKA. The patients were divided into two groups (group I, Journey II BCS TKA [106 knees]; group II, Persona PS TKA [106 knees]) after 1:1 propensity score matching.
Knee Surg Sports Traumatol Arthrosc
October 2024
Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, UK.
Purpose: This work developed a novel preclinical test of total knee replacements (TKRs) in order to explain TKR instability linked to patient dissatisfaction. It was hypothesized that stability tests on the isolated moving prostheses would provide novel comparative data on the stability and kinematics among TKR designs.
Methods: Three TKR designs, DePuy Synthes Attune MS, Stryker Triathlon and Zimmer Biomet Persona MC, were assessed using a robotic arm while flexing-extending 0-140°.
J Arthroplasty
October 2024
Center for Musculoskeletal Research, University of Tennessee-Knoxville, Knoxville, Tennessee.
Background: The non-implanted knee differs in comparison to total knee arthroplasty (TKA) designs, with regard to asymmetry and functionality of the anterior cruciate ligament and the posterior cruciate ligament. While surgeons may choose to implant either posterior stabilized (PS) or bi-cruciate stabilized (BCS) TKAs, substituting for one or both cruciate ligaments, the effects of symmetry versus asymmetry in substituting TKA designs have not been widely analyzed to determine possible benefits. Therefore, the objective of this research study was to determine if either TKA asymmetry and/or anterior ligament stabilization can lead to more normal-like kinematics and clinical benefit for patients.
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