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Baek JH, Lee SC, Ryu S, Ahn HS, Nam CH. No higher tibial post fracture rate with highly cross-linked polyethylene inserts in total knee arthroplasty at a minimum 10-year follow-up. Arch Orthop Trauma Surg 2023; 143:5807-5813. [PMID: 36720735 DOI: 10.1007/s00402-023-04789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/22/2023] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to assess tibial post fracture between highly cross-linked polyethylene (HXPE) and conventional polyethylene inserts in consecutive posterior-stabilized (PS) total knee arthroplasty (TKA) over a minimum 10-years follow-up period. METHODS Between July 2008 and December 2011, a consecutive series of 3264 primary TKAs was performed in 2098 patients using a PS total knee prosthesis at a single institution. The final cohort was classified into the HXPE group (792 cases) and the conventional group (2113 cases) according to insert material used during the procedure. RESULTS The mean follow-up period was 11.4 years in the HXPE group and 11.8 years in the conventional group. Both cases of tibial post fracture occurred in the HXPE group, a complication rate of 0.25%. These two cases required replacement with a thicker tibial insert with retention of the femoral and tibial components. There were no cases of tibial post fracture in the conventional group. CONCLUSION There was no difference in tibial post fracture rate between the HXPE group and the conventional group in PS TKA on long-term follow-up. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Ji-Hoon Baek
- Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 120, Sinmok-Ro, Yangcheon-Gu, Seoul, Republic of Korea
| | - Su Chan Lee
- Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 120, Sinmok-Ro, Yangcheon-Gu, Seoul, Republic of Korea
| | - Suengryol Ryu
- Department of Orthopaedic Surgery, Himnaera Hospital, Busan, Republic of Korea
| | - Hye Sun Ahn
- Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 120, Sinmok-Ro, Yangcheon-Gu, Seoul, Republic of Korea
| | - Chang Hyun Nam
- Joint and Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, 120, Sinmok-Ro, Yangcheon-Gu, Seoul, Republic of Korea.
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Grothues S, Hohlmann B, Zingde SM, Radermacher K. Potential for femoral size optimization for off-the-shelf implants: A CT derived implant database analysis. J Orthop Res 2022; 41:1198-1205. [PMID: 36222475 DOI: 10.1002/jor.25464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/07/2022] [Accepted: 10/08/2022] [Indexed: 02/04/2023]
Abstract
In total knee arthroplasty, the femoral implant size is chosen mainly based on the femoral anteroposterior (AP) height and mediolateral (ML) width. This choice often is a compromise, due to limited size availability. Inadequate AP fit is expected to alter flexion laxity and thus knee function. Inadequate ML fit entails underhang or overhang, which is linked to worse clinical outcomes. Hence, we aimed to find implant size distributions, which maximize population coverage, and to evaluate the sensitivity regarding error bounds and the number of implant sizes for a database of 85,143 cases. All patients in the database have been provided with a patient-specific implant in the past. For a subset of 1049 cases, three-dimensional preoperative bone surface models were available. These were used to validate whether the implant dimensions were representative of the bone dimensions. Particle Swarm Optimization was used for optimizing the implant size distribution. The deviations between implant and bone measures in the subset were found to be clinically irrelevant. Therefore, the full database of 85,143 cases was used for further analyses. A higher sensitivity of the population coverage regarding the error bounds compared to the number of implant sizes was found. For an exemplary setup of 12 optimized implant sizes and error bounds of ±1.5 mm for AP and ±3 mm for ML, a population coverage of almost 85% was achieved. In contrast, even with 30 implant sizes, a full population coverage could not be reached. Hence, remaining cases should be provided with patient-specific implants.
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Affiliation(s)
- Sonja Grothues
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - Benjamin Hohlmann
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | | | - Klaus Radermacher
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
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Kiyohara M, Hamai S, Gondo H, Higaki H, Ikebe S, Okazaki K, Nakashima Y. Comparison of in vivo knee kinematics before and after bicruciate-stabilized total knee arthroplasty during squatting. BMC Musculoskelet Disord 2021; 22:772. [PMID: 34511113 PMCID: PMC8436441 DOI: 10.1186/s12891-021-04669-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background No studies have directly evaluated kinematic changes during squatting before and after bicruciate-stabilized total knee arthroplasty (BCS-TKA) with the dual cam-post mechanism and asymmetric surfaces. This study investigated the effect of BCS-TKA on changes to pre- and postoperative skeletal knee kinematics, to identify factors associated with postoperative skeletal kinematic parameters. Methods Seventeen knees in 17 patients were prospectively recruited before primary TKA for advanced medial knee osteoarthritis. Subjects underwent BCS-TKA and were evaluated more than 1 year postoperatively. In vivo dynamic skeletal knee kinematics were evaluated using periodic radiographic images collected during squatting to quantify the tibiofemoral functional extension/flexion angle, anteroposterior (AP) translation, and axial rotation angle using image-matching techniques. Rotational alignments of femoral and tibial components were measured postoperatively using computed tomography images. Results The pre- and postoperative tibiofemoral functional extension/flexion angles during squatting were 12.2° ± 6.7°/100.1° ± 16.8° and 9.6° ± 8.6°/109.4° ± 16.8°, respectively, with a significant difference in flexion angle (p < .05). Total AP translation was significantly larger postoperatively than preoperatively (10.8 mm ± 3.7 mm vs. 14.4 mm ± 4.2 mm, respectively; p < .05). The pre- and postoperative total rotation angles were 6.6° ± 3.0° and 6.4° ± 3.7°, respectively, indicating no significant difference. The pre- and postoperative tibiofemoral functional flexion angles were significantly associated with each other (p = .0434, r = .49). The postoperative total rotation angle was significantly smaller when the total component rotational mismatch angle between the femoral and tibial components was above 5° vs. below 5° (4.6° ± 2.7° vs. 8.3° ± 3.9°, respectively; p < .05). Conclusions BCS-TKA significantly increased the tibiofemoral functional flexion angles, with larger AP translation postoperatively. Both preoperative skeletal kinematics and surgical techniques affected the skeletal kinematics of the replaced knee. A total component rotational mismatch angle greater than 5° significantly decreased postoperative total knee rotation during squatting.
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Affiliation(s)
- Masato Kiyohara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Medical-Engineering Collaboration for Healthy Longevity, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Hirotaka Gondo
- Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8503, Japan
| | - Hidehiko Higaki
- Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8503, Japan
| | - Satoru Ikebe
- Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5- 20-1 Shii, Kokuraminami-ku, Kitakyushu, Fukuoka, 802-0985, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, 162-8666, Tokyo, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Asseln M, Grothues SAGA, Radermacher K. Relationship between the form and function of implant design in total knee replacement. J Biomech 2021; 119:110296. [PMID: 33676270 DOI: 10.1016/j.jbiomech.2021.110296] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 11/29/2022]
Abstract
The implant design in total knee replacement affects postoperative functionality greatly, therefore, its optimization is of major concern. However, little is known about how implant design parameters affect active knee kinematics. Comprehensive in silico and in vitro sensitivity analyses were performed, based on one patient-specific, physical knee implant set and corresponding bone and knee implant surface geometry data. The implant surfaces were parametrized and varied systematically, resulting in 85 different knee implant surface models. In addition, four variations of extensor mechanism parameters, being the muscular attachment points defining the Q-Angle, were investigated. The variations were evaluated in a patient-specific multibody simulation model and an experimental testing rig and contributions of different implant designs and extensor mechanism parameters on kinematics were analysed. The results of the in silico and in vitro analyses showed good qualitative agreement. The highest deviations from the implant's reference kinematics were found for parameter variations of the femoral sagittal radii, the lateral trochlear elevation, the tibial sagittal slopes, the mediolateral position of the patellar ridge and the mediolateral position of the tuberositas tibiae. The implant design parameters identified with the highest functional relevance should be focused on in implant design. As the tuberositas tibiae's position constituted a main impact factor, it should also be considered during implant design and preoperative planning. Due to the competing influence of implant design parameters on active kinematics, respective parameters should be designed which are compatible to each other to avoid adverse constraints and associated functional limitations.
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Affiliation(s)
- Malte Asseln
- Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
| | | | - Klaus Radermacher
- Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
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Symmetrical cruciate-retaining versus medial pivot prostheses: The effect of intercondylar sagittal conformity on knee kinematics and contact mechanics. Comput Biol Med 2019; 108:101-110. [DOI: 10.1016/j.compbiomed.2019.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 01/28/2023]
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Tecame A, Ferrari M, Violante B, Calafiore G, Papalia R, Adravanti P. Are contemporary femoral components sizing and design likely to affect functional results in TKA? A mathematical model of an implanted knee to predict knee forces. Musculoskelet Surg 2018; 102:289-297. [PMID: 29404964 DOI: 10.1007/s12306-018-0533-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/30/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE This study is aimed to investigate the effects of the choice of femoral and tibial components on several mechanical outputs that might be associated with total knee replacement surgery outcomes using a validated computational model: the Kansas knee simulator. METHODS Two models from the same range of implants were taken into account: Model 1, the femoral component fitted the femoral epiphysis, with physiological positioning of the articulating surface using a 10-mm-thick tibial component, and in Model 2, the femoral component was 4 mm smaller than in Model 1, and a 14-mm-thick tibial component was used with a similar tibial resection and the tibio-femoral joint line was 4 mm more proximal to compensate the increased posterior bone resection and maintain proper soft-tissue tension in flexion. Changes in reaction forces and contact pressures between the components, changes in extensor muscle forces and changes in patello-femoral joint kinematics during walking gait have been studied. RESULTS While the computational model predicted that most kinematic and kinetic outputs, including tibio-femoral and patello-femoral joint motions, contact forces, pressures and areas, were similar for Model 1 and Model 2, and a dramatic difference has been found in the extensor muscle forces necessary to flex and extend the knee. To reproduce the same knee motion with a knee reconstructed as in Model 2, a patient would need to generate approximately 40% greater extensor muscle force throughout the gait cycle in order to do so. CONCLUSION As a consequence of such a large increase in the extensor muscle force, the knee motions would probably be compromised and, subsequently, a patient with a knee reconstructed as in Model 2 would be less likely to be able to reproduce normal knee function and therefore more likely to report poor outcome.
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Affiliation(s)
- A Tecame
- Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, Rome, Italy.
| | - M Ferrari
- ZimmerBiomet Italia srl, Via Milano 6, San Donato Milanese, MI, Italy
| | - B Violante
- Orthopaedic Department Knee and Hip Reconstruction - Sport Medicine, Clinical Institute Sant' Ambrogio, IRCCS Galeazzi, Via Riccardo Galeazzi 4, Milan, Italy
| | - G Calafiore
- Department of Orthopaedic and Trauma Surgery, Città di Parma Clinic, Piazzale Athos Maestri 5, Parma, Italy
| | - R Papalia
- Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, Rome, Italy
| | - P Adravanti
- Department of Orthopaedic and Trauma Surgery, Città di Parma Clinic, Piazzale Athos Maestri 5, Parma, Italy
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Murakami K, Hamai S, Okazaki K, Gondo H, Wang Y, Ikebe S, Higaki H, Shimoto T, Mizu-Uchi H, Akasaki Y, Nakashima Y. Knee kinematics in bi-cruciate stabilized total knee arthroplasty during squatting and stair-climbing activities. J Orthop 2018; 15:650-654. [PMID: 29881213 DOI: 10.1016/j.jor.2018.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/06/2018] [Indexed: 11/27/2022] Open
Abstract
This study aimed to evaluate clinical outcomes and in vivo kinematics of bi-cruciate stabilized (BCS) total knee arthroplasty (TKA), using image-matching techniques. We analyzed tibiofemoral anteroposterior translation, axial rotation, and anterior/posterior cam-post contact for 22 BCS TKAs during squatting and stair-climbing. The functional activities on the 2011 Knee Society Score were significantly improved from 36 to 71. The tibiofemoral translation and axial rotation during squatting/stair-climbing were 16.1 mm/7.1 mm and 2.5° external/1.1° internal, respectively. Anterior/posterior cam-post contacts were observed during squatting (14%/96%) and stair-climbing (27%/96%). In conclusion, BCS TKA produced physiological sagittal plane kinematics during activities with favorable clinical outcomes.
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Affiliation(s)
- Koji Murakami
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Hirotaka Gondo
- Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka 813-8583, Japan
| | - Yifeng Wang
- Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka 813-8583, Japan
| | - Satoru Ikebe
- Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminami-ku, Kitakyushu, Fukuoka 802-0985, Japan
| | - Hidehiko Higaki
- Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka 813-8583, Japan
| | - Takeshi Shimoto
- Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan
| | - Hideki Mizu-Uchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yukio Akasaki
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Murakami K, Hamai S, Moro-Oka T, Okazaki K, Higaki H, Shimoto T, Ikebe S, Nakashima Y. Variable tibiofemoral articular contact stress in fixed-bearing total knee arthroplasties. Orthop Traumatol Surg Res 2018; 104:177-183. [PMID: 29274859 DOI: 10.1016/j.otsr.2017.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/14/2017] [Accepted: 11/17/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rotational allowance at the tibiofemoral joint would be required during deep flexion. However, the amount of flexion and rotation has not been investigated in modern total knee arthroplasty (TKA) designs. The present study aimed to determine the contact stress in five posterior-stabilized fixed-bearing TKA designs. HYPOTHESIS We hypothesized that the contact area and stresses at the tibiofemoral articular surfaces vary according to the type of implant design and tested condition. MATERIALS AND METHODS The contact area and mean and peak contact stresses at the tibiofemoral articular surfaces were determined when a compressive load of 1200N was applied to a NexGen LPS Flex, Scorpio NRG, Genesis II, PFC Sigma, and Foundation implant. Measurements were performed at 0° and 45° flexion with 0°, 5°, 10°, and 15° rotation, and at 90° and 135° flexion with 0, 5°, 10°, 15°, and 20° rotation. RESULTS The LPS Flex showed that the femoral component could not achieve 20° rotation at 135° flexion. The Scorpio NRG showed less than 20MPa of contact stress at all conditions. The Genesis II showed higher contact stress than 20MPa at 135° flexion with 20° rotation. The PFC Sigma showed that the femoral component could not achieve >10° rotation at any flexion angle. The Foundation showed more than 20MPa of contact stress at 90° flexion with 20° rotation and at 135° flexion with 10°, 15°, and 20° rotation. DISCUSSION Surgeons should be more aware of the variable contact conditions of the tibiofemoral articular surfaces in individual TKA designs. LEVEL OF EVIDENCE Level IV, basic science study.
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Affiliation(s)
- K Murakami
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
| | - S Hamai
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan.
| | - T Moro-Oka
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan; Moro-oka orthopaedic hospital, 101-3, Katawana Nakagawa-machi, 811-1201 Chikushi-gun, Fukuoka, Japan
| | - K Okazaki
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
| | - H Higaki
- Department of biorobotics, faculty of engineering, Kyushu Sangyo university, 2-3-1, Matsugadai, 813-8583 Higashi-ku, Fukuoka, Japan
| | - T Shimoto
- Department of information and systems engineering, faculty of information engineering, Fukuoka institute of technology, 3-30-1, Wajiro-higashi, 811-0295 Higashi-ku, Fukuoka, Japan
| | - S Ikebe
- Department of biorobotics, faculty of engineering, Kyushu Sangyo university, 2-3-1, Matsugadai, 813-8583 Higashi-ku, Fukuoka, Japan
| | - Y Nakashima
- Department of orthopaedic surgery, Graduate school of medical sciences, Kyushu university, 1-3-3, Maidashi, 812-8582 Higashi-ku, Fukuoka, Japan
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Murakami K, Hamai S, Okazaki K, Ikebe S, Nakahara H, Higaki H, Shimoto T, Mizu-Uchi H, Kuwashima U, Iwamoto Y. Kinematic analysis of stair climbing in rotating platform cruciate-retaining and posterior-stabilized mobile-bearing total knee arthroplasties. Arch Orthop Trauma Surg 2017; 137:701-711. [PMID: 28289890 DOI: 10.1007/s00402-017-2662-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The aim of our study was to compare and contrast the effects of two types of mobile-bearing total knee arthroplasties (TKA), namely, the cruciate-retaining (CR) and posterior-stabilized (PS) TKAs, on clinical outcomes and in vivo kinematics during stair climbing. MATERIALS AND METHODS The Press-Fit Condylar Sigma rotating platform was used for both CR and PS TKAs. Patient-reported outcomes were assessed using the 2011 Knee Society Score. Quadriceps muscle strength was evaluated by isokinetic dynamometry. In vivo kinematics were evaluated using periodic sagittal plane radiographic images obtained during stair climbing to quantify anteroposterior (AP) tibiofemoral translation, implant flexion and axial rotation angles using image-matching techniques. Outcomes were evaluated in 20 TKAs, which had been undergone with clinical success, including ten knees with CR types and ten knees with PS types. RESULTS There were no significant differences between the CR and PS TKA groups (p > 0.05) in isometric extensor torque (1.0 ± 0.2 and 1.1 ± 0.6 N m/kg, respectively) or patient-reported score for stair climbing function (4.0 ± 0.5 and 3.8 ± 0.9, respectively). Both types of TKAs showed stable AP translation in the mid range of knee flexion and paradoxical translation in the low range of flexion, with limited rotation, during stair climbing. There were no significant differences between the CR and PS TKA groups (P > 0.05) in anterior translation from 80° to 40° of knee flexion (4.2 ± 1.2 and 3.5 ± 1.6 mm, respectively), posterior translation from 40° to 10° of knee flexion (2.3 ± 1.9 and 2.0 ± 1.5 mm, respectively), and total external rotation (2.8° ± 4.9° and 0.5° ± 5.0°, respectively). CONCLUSIONS Both CR and PS types of rotating platform mobile-bearing TKAs provided reproducible knee joint kinematics during stair climbing and equivalent clinical outcomes. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Koji Murakami
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Katai Orthopaedic Hospital, 132-1 Okuma Kasuya-machi, Kasuya-gun, Fukuoka, 811-2302, Japan
| | - Satoru Ikebe
- Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8583, Japan
| | - Hiroyuki Nakahara
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hidehiko Higaki
- Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8583, Japan
| | - Takeshi Shimoto
- Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan
| | - Hideki Mizu-Uchi
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Umito Kuwashima
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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