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Comparison of posterior-stabilized, cruciate-retaining, and medial-stabilized knee implant motion during gait. | LitMetric

AI Article Synopsis

  • Accurate knee joint motion knowledge is essential to assess how different implant designs affect performance and wear, leading to a study comparing 6-degree-of-freedom (6-DOF) motion of three types of knee implants during walking.
  • A mobile biplane X-ray system measured the motion of patients with posterior-stabilized (PS), cruciate-retaining (CR), and medial-stabilized (MS) knee implants, revealing that MS knees showed more favorable kinematic profiles compared to PS and CR knees.
  • Notably, the MS design mimicked the healthy knee motion better, exhibiting less anterior translation of the femur and differences in the joint center of rotation compared to PS and CR implants.

Article Abstract

Accurate knowledge of knee joint motion is needed to evaluate the effects of implant design on functional performance and component wear. We conducted a randomized controlled trial to measure and compare 6-degree-of-freedom (6-DOF) kinematics and femoral condylar motion of posterior-stabilized (PS), cruciate-retaining (CR), and medial-stabilized (MS) knee implant designs for one cycle of walking. A mobile biplane X-ray imaging system was used to accurately measure 6-DOF tibiofemoral motion as patients implanted with PS (n = 23), CR (n = 25), or MS (n = 26) knees walked over ground at their self-selected speeds. Knee flexion angle did not differ significantly between the three designs. Relative movements of the femoral and tibial components were generally similar for PS and CR with significant differences observed only for anterior tibial drawer. Knee kinematic profiles measured for MS were appreciably different: external rotation and abduction of the tibia were increased while peak-to-peak anterior drawer was significantly reduced for MS compared with PS and CR. Anterior-posterior drawer and medial-lateral shift of the tibia were strongly coupled to internal-external rotation for MS, as was anterior-posterior translation of the contact center in the lateral compartment. MS exhibited the least amount of paradoxical anterior translation of the femur relative to the tibia during knee flexion. The joint center of rotation in the transverse plane was located in the lateral compartment for PS and CR and in the medial compartment for MS. Substantial differences were evident in 6-DOF knee kinematics between the healthy knee and all three prosthetic designs. Overall, knee kinematic profiles observed for MS resemble those of the healthy joint more closely than PS and CR.

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http://dx.doi.org/10.1002/jor.24613DOI Listing

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