Evidence map›Paper›PMID 33388940›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Asymmetrical tibial polyethylene geometry-cruciate retaining total knee arthroplasty does not fully restore in-vivo articular contact kinematics during strenuous activities.

Christian Klemt, John Drago, Venkatsaiakhil Tirumala, Young-Min Kwon

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Christian KlemtBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
John DragoBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Venkatsaiakhil TirumalaBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Young-Min KwonBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. ymkwon@mgh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA new CR TKA design with concave medial and convex lateral tibial polyethylene bearing components was introduced recently to improve functional outcomes. This study aimed to investigate in-vivo articular contact kinematics in unilateral asymmetrical tibial polyethylene geometry CR TKA patients during strenuous knee flexion activities.

methodsFifteen unilateral CR TKA patients (68.4 ± 5.8 years; 6 male/9 female) were evaluated for both knees during sit-to-stand, single-leg deep lunges and step-ups using validated combined computer tomography and dual fluoroscopic imaging system. Medial and lateral condylar contact positions were quantified during weight-bearing flexion activities. The Wilcoxon signed-rank test was performed to determine if there is a significant difference in articular contact kinematics during strenuous flexion activities between CR TKA and the non-operated knees.

resultsContact excursions of the lateral condyle in CR TKAs were significantly more anteriorly located than the contralateral non-operated knee during sit-to-stand (3.7 ± 4.8 mm vs - 7.8 ± 4.3 mm) and step-ups (- 1.5 ± 3.2 mm vs - 6.3 ± 5.8 mm). Contact excursions of the lateral condyle in CR TKAs were significantly less laterally located than the contralateral non-operated knee during sit-to-stand (21.4 ± 2.8 mm vs 24.5 ± 4.7 mm) and single-leg deep lunges (22.6 ± 4.4 mm vs 26.2 ± 5.7 mm, p < 0.05). Lateral condyle posterior rollback was not fully restored in CR TKA patients during sit-to-stand (9.8 ± 6.7 mm vs 12.9 ± 8.3 mm) and step-ups (8.1 ± 4.8 mm vs 12.2 ± 6.4 mm). Lateral pivoting patterns were observed in 80%, 73% and 69% of patients during sit-to-stand, step-ups and single-leg deep lunges respectively.

conclusionAlthough lateral femoral rollback and lateral pivoting patterns were observed during strenuous functional daily activities, asymmetric contact kinematics still persisted in unilateral CR TKA patients. This suggests the specific investigated contemporary asymmetrical tibial polyethylene geometry CR TKA design evaluated in this study does not fully replicate healthy knee contact kinematics during strenuous functional daily activities. LEVEL OF EVIDENCE: III.

Indexed as

Arthroplasty, Replacement, KneeKnee ProsthesisBiomechanical PhenomenaFemaleHumansKnee JointMalePolyethyleneRange of Motion, ArticularTibiaPolyethyleneContact analysisFunctional activityIn-vivo kinematicsLungeTotal knee arthroplastyTotal knee replacement

Identifiers

PMID33388940

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.