Background: Restoration of natural knee kinematics for a designed mechanism in knee implants is required to achieve full knee function in total knee arthroplasty (TKA). In different posterior-stabilized TKAs, there are wide variations in tibiofemoral surfaces and post-cam design. However, it is not known whether these design variations preserve natural knee kinematics. The purpose of this study was to determine the most appropriate tibiofemoral surface and post-cam designs to restore natural knee kinematics of the TKA.
Methods: A subject-specific finite element knee modal was used to evaluate tibiofemoral surface and post-cam design. Three different posts in convex, straight, and concave geometries were considered with a fixed circular cam design in this study. In addition, this post-cam design was applied to three different surface conformities for conforming, medial pivot, and subject anatomy mimetic tibiofemoral surfaces. We evaluated the femoral rollback, internal-external rotation, and quadriceps muscle force under a deep-knee-bend condition.
Results: The three different tibiofemoral conformities showed that the convex post provided the most natural-knee-like femoral rollback. This was also observed in internal rotation. In surface conformity, subject anatomy mimetic tibiofemoral surfaces showed the most natural -knee-like kinematics and quadriceps force.
Conclusions: This study confirmed that convex post design and subject anatomy mimetic tibiofemoral surfaces provided the most natural-knee-like kinematics. This study suggested that post-cam design and tibiofemoral surface conformity should be considered in conventional and customized TKA.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303222 | PMC |
| http://dx.doi.org/10.1186/s40634-018-0167-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Kinematic Patterns of Different Loading Profiles Before and After Total Knee Arthroplasty: A Cadaveric Study.
Bioengineering (Basel)
October 2024
Research & Development, Aesculap AG, 78532 Tuttlingen, Germany.
One of the major goals of total knee arthroplasty (TKA) is to restore the physiological function of the knee. In order to select the appropriate TKA design for a specific patient, it would be helpful to understand whether there is an association between passive knee kinematics intraoperatively and during complex activities, such as ascending stairs. Therefore, the primary objective of this study was to compare the anterior-posterior (AP) range of motion during simulated passive flexion and stair ascent at different conditions in the same knees using a six-degrees-of-freedom joint motion simulator, and secondary, to identify whether differences between TKA designs with and without a post-cam mechanism can be detected during both activities, and if one design is superior in recreating the AP translation of the native knee.
View Article and Find Full Text PDFEffect of single-radius design on in vivo kinematics during stair activities after total knee arthroplasty.
J Orthop Surg (Hong Kong)
April 2024
Department of Orthopedic Biomaterial Science, Osaka UniversityGraduate School of Medicine, Suita, Japan.
Background: The single-radius design is one of the major total knee arthroplasty (TKA) designs and widely used all over the world. The objective of this study was to compare in vivo kinematics between the anteroposterior (AP) single-radius design with mediolateral (ML) single-radius (Non Restricted Geometry; NRG) and ML dual-radius (Triathlon) during stair activities.
Methods: A total of 21 knees in 18 patients (NRG group: 10 knees in 7 patients, Triathlon group: 11 knees in 11 patients) with a clinically successful posterior stabilized TKA were examined.
PCL preservation or sacrifice does not influence clinical outcomes and survivorship at mid-term follow-up of a J-curve CR total knee replacement with a medial congruent liner and a functional coronal alignment.
Arch Orthop Trauma Surg
January 2024
Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, UOC Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati, 57, 25124, Brescia, Italy.
Background: In recent years, increasing interest has arisen for medial pivoting TKA implants, designed to mimic the physiological knee kinematics, maximizing the contact area on the medial compartment of the knee, increasing anterior-posterior stability, and contributing to a ball-in-socket effect that allows the posterior cruciate sacrifice without a post-CAM mechanism. The medial congruent liner works with a J-curve cruciate-retaining (CR) femur without a real ball-in-socket design. The aim of this study was to evaluate the clinical outcomes and survival of these implants, with or without PCL sparing, at a medium follow-up.
View Article and Find Full Text PDFValidation of a novel finite-element model for evaluating patellofemoral forces and stress during squatting after posterior-stabilized total knee arthroplasty.
Orthop Traumatol Surg Res
September 2023
Laboratoire de mécanique et génie civil (LMGC), CNRS, Montpellier University of Excellence (MUSE), 860, rue de St-Priest, 34090 Montpellier, France; Department of Orthopaedic Surgery, Lower limb Surgery Unit, Lapeyronie University Hospital, Montpellier University, 371, avenue Gaston-Giraud, 34295 Montpellier, France. Electronic address:
Introduction: Several studies have documented the relationship between patellofemoral pain and patient dissatisfaction after total knee arthroplasty (TKA). However, few computer simulations have been designed to evaluate the patellofemoral joint during flexion. The aim of this study was to validate a new computational simulation, driven by forces and moments, and to analyze patellofemoral reaction forces and stress under squat loading conditions after TKA implantation.
View Article and Find Full Text PDFPosterior-stabilized total knee arthroplasty kinematics and joint laxity: A hybrid biomechanical study.
Arthroplasty
December 2022
London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
Background: Posterior-stabilized (PS)-total knee arthroplasty (TKA) arose as an alternative to cruciate-retaining (CR)-TKA in the 1970s. Since then, it has become a popularly utilized TKA design with outcomes comparable to CR-TKA. The post-cam mechanism is unique to PS-TKA as it substitutes the function of the posterior cruciate ligament (PCL).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!