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Clinical Orthopaedics and Related Research

, Volume 466, Issue 10, pp 2491–2499 | Cite as

Changes in Knee Kinematics Reflect the Articular Geometry after Arthroplasty

  • Anthony M. J. Bull
  • Oliver Kessler
  • Mahbub Alam
  • Andrew A. Amis
Original Article

Abstract

We hypothesized changes in rotations and translations after TKA with a fixed-bearing anterior cruciate ligament (ACL)-sacrificing but posterior cruciate ligament (PCL)-retaining design with equal-sized, circular femoral condyles would reflect the changes of articular geometry. Using 8 cadaveric knees, we compared the kinematics of normal knees and TKA in a standardized navigated position with defined loads. The quadriceps was tensed and moments and drawer forces applied during knee flexion-extension while recording the kinematics with the navigation system. TKA caused loss of the screw-home; the flexed tibia remained at the externally rotated position of normal full knee extension with considerably increased external rotation from 63° to 11° extension. The range of internal-external rotation was shifted externally from 30° to 20° extension. There was a small tibial posterior translation from 40° to 90° flexion. The varus-valgus alignment and laxity did not change after TKA. Thus, navigated TKA provided good coronal plane alignment but still lost some aspects of physiologic motion. The loss of tibial screw-home was related to the symmetric femoral condyles, but the posterior translation in flexion was opposite the expected change after TKA with the PCL intact and the ACL excised. Thus, the data confirmed our hypothesis for rotations but not for translations. It is not known whether the standard navigated position provides the best match to physiologic kinematics.

Keywords

Anterior Cruciate Ligament Femoral Component Posterior Cruciate Ligament Tibial Rotation Intact Knee 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank D. Lucas, who performed much of the experimental work; however, the analysis, discussion, and conclusions are those of the authors alone. We thank J. L. Moctezuma, H. Boschert, and P. Zimmerman of Stryker (Leibinger) for their support with data recording using the Stryker Navigation System; and P. Wilson of the Mechanical Engineering Department for technical support. We also thank Prof P. Aichroth for advice.

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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Anthony M. J. Bull
    • 1
  • Oliver Kessler
    • 2
  • Mahbub Alam
    • 3
    • 4
  • Andrew A. Amis
    • 4
    • 5
  1. 1.Department of BioengineeringImperial College LondonLondonUK
  2. 2.Stryker OrthopaedicsThalwilSwitzerland
  3. 3.St Richard’s HospitalChichesterUK
  4. 4.Department of Mechanical EngineeringImperial College LondonLondonUK
  5. 5.Department of Musculoskeletal SurgeryImperial College LondonLondonUK

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