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In-vivo kinematics of high-flex posterior-stabilized total knee prosthesis designed for Asian populations

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Abstract

Purpose

The purpose of this study was to determine in-vivo kinematics of our developed posterior-stabilized (PS) total knee prosthesis for Asian populations in comparison with a popular high-flexion PS prosthesis.

Methods

We analyzed 62 osteoarthritic knees: 31 knees with the new PS prosthesis (group A) and 31 knees with a popular high-flexion PS prosthesis (group B). Radiographic knee images were taken during standing, lunge, and kneeling activities. The three-dimensional position and orientation of the implant components were determined using model-based shape matching techniques.

Results

Group A showed slightly greater implant flexion angles compared with knees with conventional prosthesis at maximum lunge (average: 119 vs. 110°, p = 0.001), and at maximum kneeling (121 vs. 114°, p = 0.004), although the range of motion was not significantly different. The femoral centre positions were more posterior in group A at standing, at 90° lunge, at maximum lunge (-9 and -7 mm, p = 0.004), at 90° kneeling, and at maximum kneeling (-9 vs. -7 mm, p = 0.016), and posterior translations of the femoral center were greater at 90° knee flexion postures. The femoral centre positions had a strong negative correlation with implant flexion angles at maximum lunge in group B (r = -0.893, p < 0.001), but not in group A (p = 0.242).

Conclusions

The new PS prosthesis designed for Asian knee morphology achieved flexion angles and range of motion at least comparable to that of conventional high-flexion PS prosthesis. The femoral roll-back pattern, however, is different from a conventional knee, reflecting the post/cam design.

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Acknowledgments

The authors thank Scott A. Banks, PhD for his continuous support on kinematic analysis. We also thank Bryan P. Conrad, PhD for his careful review of the manuscript and for giving us useful suggestions, and Tomoyuki Mizuguchi for his valuable advice on image processing. We received research support from Kyocera Medical and Zimmer.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Toshifumi Watanabe, Takeshi Muneta, Hideyuki Koga, Masafumi Horie, Tomomasa Nakamura, Koji Otabe, Yusuke Nakagawa, Mai Katakura & Ichiro Sekiya

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  1. Toshifumi Watanabe
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  2. Takeshi Muneta
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  3. Hideyuki Koga
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  4. Masafumi Horie
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  5. Tomomasa Nakamura
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  7. Yusuke Nakagawa
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  8. Mai Katakura
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  9. Ichiro Sekiya
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Correspondence to Toshifumi Watanabe.

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Watanabe, T., Muneta, T., Koga, H. et al. In-vivo kinematics of high-flex posterior-stabilized total knee prosthesis designed for Asian populations. International Orthopaedics (SICOT) 40, 2295–2302 (2016). https://doi.org/10.1007/s00264-016-3176-5

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  • DOI: https://doi.org/10.1007/s00264-016-3176-5

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