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Weight-bearing status affects in vivo kinematics following mobile-bearing unicompartmental knee arthroplasty

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Abstract

Purpose

The effects of weight bearing (WB) on knee kinematics following mobile-bearing unicompartmental knee arthroplasty (UKA) remain unknown. The purpose of this study was to clarify the effects of WB on in vivo kinematics of mobile-bearing UKA during high knee flexion activities.

Methods

The kinematics of UKA were evaluated under fluoroscopy during squatting (WB) and active-assisted knee flexion (non-weight bearing, NWB). Range of motion, femoral axis rotation relative to the tibia, anteroposterior (AP) translation of the medial and lateral sides, and kinematic pathway were measured.

Results

There were no differences in knee flexion range and external rotation of the femur in each flexion angle between the WB conditions. The amount of femoral external rotation between minimum flexion and 60° of flexion during WB was significantly larger than that during NWB, and that between 60° and 130° of flexion during NWB was significantly larger than that during WB. There were no differences in medial AP translation of the femur in each flexion angle between the WB conditions. However, on the lateral side, posterior translation of 52.9 ± 12.7% was observed between minimum flexion and 130° of flexion during WB. During NWB, there was no significant translation between minimum flexion and 60° of flexion; beyond 60° of flexion, posterior translation was 41.6 ± 8.7%. Between 20° and 80° of flexion, the lateral side in WB was located more posteriorly than in NWB (p < 0.05).

Conclusion

Mobile-bearing UKA has good anterior stability throughout the range of knee flexion. WB status affects the in vivo kinematics following mobile-bearing UKA.

Level of evidence

III.

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Abbreviations

WB:

Weight bearing

UKA:

Unicompartmental knee arthroplasty

TKA:

Total knee arthroplasty

PS-TKA:

Posterior-stabilized TKA

CR-TKA:

Cruciate-retaining TKA

BCS-TKA:

Bicruciate-stabilized TKA

2D:

Two-dimensional

3D:

Three-dimensional

CAD:

Computer-aided design

OA:

Osteoarthritis

HKA:

Hip–knee–ankle

ANOVA:

Analysis of variance

KSS:

Knee Society Score

ACL:

Anterior cruciate ligament

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Author information

Correspondence to Hiroshi Inui.

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The authors declare that they have no conflict of interest.

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This research did not receive any special grant from funding agencies in the public, commercial, or not-for-profit sectors.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee (The University of Tokyo: 10462-(1), Osaka University: 13106).

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Informed consent was obtained from all individual participants included in the study.

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Kono, K., Inui, H., Tomita, T. et al. Weight-bearing status affects in vivo kinematics following mobile-bearing unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc (2020). https://doi.org/10.1007/s00167-020-05893-x

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Keywords

  • Unicompartmental knee arthroplasty
  • High-flexion
  • Kinematics
  • Weight-bearing