Knee kinematics after cruciate retaining highly congruent mobile bearing total knee arthroplasty: An in vivo dynamic RSA study

Umberto Cardinale, Laura Bragonzoni, Marco Bontempi, Domenico Alesi, Tommaso Roberti di Sarsina, Mirco Lo Presti, Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, Francesco Iacono

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: This work presents a kinematic evaluation of a cruciate retaining highly congruent mobile bearing total knee arthroplasty design using dynamic Roentgen sterephotogrammetric analysis. The aim was to understand the effect of this implant design on the kinematics of prosthetic knees during dynamic activities.

METHODS: A cohort of 15 patients was evaluated at nine month follow-up after surgery. The mean age was 74.8 (range 66-85) years. The kinematics was evaluated using the Grood and Suntay decomposition and the Low-Point (LP) methods.

RESULTS: From sitting to standing up position, the femoral component internally rotated (from -11.3 ± 0.2° to -7.0 ± 0.2°). Varus-valgus rotations were very close to 0° during the whole motor task. LP of medial condyle moved from an anterior position of 12.0 ± 0.2 mm to a posterior position of -12.4 ± 0.2 mm; LP of the lateral condyle moved from an anterior position of 8.1 ± 0.2 mm to a posterior position of -12.4 ± 0.2 mm, showing a bi-condylar rollback where both condyles moved parallel backward. Moreover, the femoral component showed anterior translation with respect to the tibia from 80° to 20° (from -4.9 ± 0.2 mm to 3.3 ± 0.2 mm), then a posterior translation from 20° to full extension was identified (from 3.3 ± 0.2 mm to 0.5 ± 0.2 mm).

CONCLUSIONS: Paradoxical anterior femoral translation and absence of medial-pivoting motion were recorded, highlighting the role of the symmetric deep dishes insert as main driver of the kinematic of this TKA design.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalKnee
DOIs
Publication statusE-pub ahead of print - Dec 21 2019

Keywords

  • Cruciate retaining
  • Dynamic RSA
  • Kinematics
  • Knee
  • Mobile bearing
  • TKA

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