Skip to main content

Advertisement

SpringerLink
Log in

Anatomy-mimetic design preserves natural kinematics of knee joint in patient-specific mobile-bearing unicompartmental knee arthroplasty

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aims to evaluate whether different tibial–femoral conformities for patient-specific mobile-bearing unicompartmental knee arthroplasties (UKAs) preserve natural knee kinematics, using computational simulations.

Methods

Different designs for patient-specific mobile-bearing UKAs were evaluated using finite element analysis. Three designs for the identical femoral component were considered: flat (non-conforming design), anatomy-mimetic, and conforming for the tibial insert.

Results

The conforming design for the patient-specific mobile-bearing UKAs exhibited a 1.2 mm and 0.7° decrease in the translation and rotation, respectively, in the swing phase compared with those of the natural knee. In addition, the femoral rollback and internal rotation were 2.6 mm and 1.2° lower, respectively, than those of the natural knee, for the conforming design under the deep-knee-bend condition. The flat design for the patient-specific mobile-bearing UKAs exhibited a 2.2 mm and 1.4° increase in the femoral rollback and rotation compared with the natural knee under the deep-knee-bend condition. The anatomy-mimetic patient-specific mobile-bearing UKAs best preserved the natural knee kinematics under the gait and deep-knee-bend loading conditions.

Conclusions

The kinematics of the loading conditions in patient-specific mobile-bearing UKAs was determined to closely resemble those of a native knee. In additional, by replacing the anatomy-mimetic design with a mobile-bearing, natural knee kinematics during gait and deep-knee-bend motions is preserved. These results confirm the importance of tibiofemoral conformity in preserving native knee kinematics in patient-specific mobile-bearing UKA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of 10 years of follow-up. J Bone Joint Surg Am 87:999–1006

    Article  Google Scholar 

  2. Blankevoort L, Huiskes R (1996) Validation of a three-dimensional model of the knee. J Biomech 29:955–961

    Article  CAS  Google Scholar 

  3. Carpenter DP, Holmberg RR, Quartulli MJ, Barnes CL (2014) Tibial plateau coverage in UKA: a comparison of patient specific and off-the-shelf implants. J Arthroplasty 29:1694–1698

    Article  Google Scholar 

  4. Catani F, Benedetti MG, Bianchi L, Marchionni V, Giannini S, Leardini A (2012) Muscle activity around the knee and gait performance in unicompartmental knee arthroplasty patients: a comparative study on fixed- and mobile-bearing designs. Knee Surg Sports Traumatol Arthrosc 20:1042–1048

    Article  Google Scholar 

  5. Fitz W (2009) Unicompartmental knee arthroplasty with use of novel patient-specific resurfacing implants and personalized jigs. J Bone Joint Surg Am 91(Suppl 1):69–76

    Article  Google Scholar 

  6. Fox AJ, Bedi A, Rodeo SA (2012) The basic science of human knee menisci: structure, composition, and function. Sports Health 4:340–351

    Article  Google Scholar 

  7. Freeman MA, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38:197–208

    Article  CAS  Google Scholar 

  8. Furnes O, Espehaug B, Lie SA, Vollset SE, Engesaeter LB, Havelin LI (2007) Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with cement. J Bone Joint Surg Am 89:519–525

    Article  CAS  Google Scholar 

  9. Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman JH (2004) Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. Knee 11:379–384

    Article  CAS  Google Scholar 

  10. Godest AC, Beaugonin M, Haug E, Taylor M, Gregson PJ (2002) Simulation of a knee joint replacement during a gait cycle using explicit finite element analysis. J Biomech 35:267–275

    Article  CAS  Google Scholar 

  11. Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144

    Article  CAS  Google Scholar 

  12. Halloran JP, Clary CW, Maletsky LP, Taylor M, Petrella AJ, Rullkoetter PJ (2010) Verification of predicted knee replacement kinematics during simulated gait in the Kansas knee simulator. J Biomech Eng 132:081010

    Article  Google Scholar 

  13. Hamilton TW, Rizkalla JM, Kontochristos L, Marks BE, Mellon SJ, Dodd CAF, Pandit HG, Murray DW (2017) The interaction of caseload and usage in determining outcomes of unicompartmental knee arthroplasty: a meta-analysis. J Arthroplasty 32:3228–3237.e3222

    Article  Google Scholar 

  14. Heyse TJ, El-Zayat BF, De Corte R, Chevalier Y, Scheys L, Innocenti B, Fuchs-Winkelmann S, Labey L (2014) UKA closely preserves natural knee kinematics in vitro. Knee Surg Sports Traumatol Arthrosc 22:1902–1910

    Article  Google Scholar 

  15. Hopkins AR, New AM, Rodriguez-y-Baena F, Taylor M (2010) Finite element analysis of unicompartmental knee arthroplasty. Med Eng Phys 32:14–21

    Article  Google Scholar 

  16. Inoue S, Akagi M, Asada S, Mori S, Zaima H, Hashida M (2016) The valgus inclination of the tibial component increases the risk of medial tibial condylar fractures in unicompartmental knee arthroplasty. J Arthroplasty 31:2025–2030

    Article  Google Scholar 

  17. Kang KT, Kim SH, Son J, Lee YH, Chun HJ (2016) Computational model-based probabilistic analysis of in vivo material properties for ligament stiffness using the laxity test and computed tomography. J Mater Sci Mater Med 27:183

    Article  Google Scholar 

  18. Kang KT, Koh YG, Son J, Kim SJ, Choi S, Jung M, Kim SH (2017) Finite element analysis of the biomechanical effects of 3 posterolateral corner reconstruction techniques for the knee joint. J Arthroscopy 33:1537–1550

    Article  Google Scholar 

  19. Kang KT, Koh YG, Son J, Kwon OR, Park KK (2018) Flexed femoral component improves kinematics and biomechanical effect in posterior stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27:1174–1181

    Article  Google Scholar 

  20. Kang KT, Kwon SK, Son J, Kwon OR, Lee JS, Koh YG (2018) The increase in posterior tibial slope provides a positive biomechanical effect in posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 26:3188–3195

    Article  Google Scholar 

  21. Kang KT, Son J, Suh DS, Kwon SK, Kwon OR, Koh YG (2018) Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: a finite element analysis. Bone Joint Res 7:20–27

    Article  Google Scholar 

  22. Koeck FX, Beckmann J, Luring C, Rath B, Grifka J, Basad E (2011) Evaluation of implant position and knee alignment after patient-specific unicompartmental knee arthroplasty. Knee 18:294–299

    Article  Google Scholar 

  23. Koh YG, Son J, Kwon OR, Kwon SK, Kang KT (2018) Patient-specific design for articular surface conformity to preserve normal knee mechanics in posterior stabilized total knee arthroplasty. Biomed Mater Eng 29:401–414

    CAS  PubMed  Google Scholar 

  24. Koh YG, Son J, Kwon OR, Kwon SK, Kang KT (2018) Tibiofemoral conformity variation offers changed kinematics and wear performance of customized posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27:1213–1223

    Article  Google Scholar 

  25. Koh YG, Son J, Kwon SK, Kim HJ, Kwon OR, Kang KT (2017) Preservation of kinematics with posterior cruciate-, bicruciate- and patient-specific bicruciate-retaining prostheses in total knee arthroplasty by using computational simulation with normal knee model. Bone Joint Res 6:557–565

    Article  Google Scholar 

  26. Kutzner I, Heinlein B, Graichen F, Bender A, Rohlmann A, Halder A, Beier A, Bergmann G (2010) Loading of the knee joint during activities of daily living measured in vivo in five subjects. J Biomech 43:2164–2173

    Article  CAS  Google Scholar 

  27. Kwon OR, Kang KT, Son J, Kwon SK, Jo SB, Suh DS, Choi YJ, Kim HJ, Koh YG (2014) Biomechanical comparison of fixed- and mobile-bearing for unicomparmental knee arthroplasty using finite element analysis. J Orthop Res 32:338–345

    Article  Google Scholar 

  28. Liddle AD, Pandit H, Judge A, Murray DW (2015) Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Joint J 97-b:793–801

    Article  CAS  Google Scholar 

  29. Mochizuki T, Sato T, Blaha JD, Tanifuji O, Kobayashi K, Yamagiwa H, Watanabe S, Matsueda M, Koga Y, Omori G, Endo N (2014) Kinematics of the knee after unicompartmental arthroplasty is not the same as normal and is similar to the kinematics of the knee with osteoarthritis. Knee Surg Sports Traumatol Arthrosc 22:1911–1917

    Article  Google Scholar 

  30. Mochizuki T, Sato T, Tanifuji O, Kobayashi K, Koga Y, Yamagiwa H, Omori G, Endo N (2013) In vivo pre- and postoperative three-dimensional knee kinematics in unicompartmental knee arthroplasty. J Orthop Sci 18:54–60

    Article  Google Scholar 

  31. Peersman G, Slane J, Vuylsteke P, Fuchs-Winkelmann S, Dworschak P, Heyse T, Scheys L (2017) Kinematics of mobile-bearing unicompartmental knee arthroplasty compared to native: results from an in vitro study. Arch Orthop Trauma Surg 137:1557–1563

    Article  Google Scholar 

  32. Pena E, Calvo B, Martinez MA, Palanca D, Doblare M (2006) Why lateral meniscectomy is more dangerous than medial meniscectomy. A finite element study. J Orthop Res Off Publ Orthop Res Soc 24:1001–1010

    Article  Google Scholar 

  33. Smith TO, Hing CB, Davies L, Donell ST (2009) Fixed versus mobile bearing unicompartmental knee replacement: a meta-analysis. Orthop Traumatol Surg Res 95:599–605

    Article  CAS  Google Scholar 

  34. Steklov N, Slamin J, Srivastav S, D’Lima D (2010) Unicompartmental knee resurfacing: enlarged tibio-femoral contact area and reduced contact stress using novel patient-derived geometries. Open Biomed Eng J 4:85–92

    Article  CAS  Google Scholar 

  35. Van Den Heever DJ, Scheffer C, Erasmus PJ, Dillon EM (2010) Contact stresses in a patient-specific unicompartmental knee replacement. Conf Proc IEEE Eng Med Biol Soc 2010:5113–5116

    Google Scholar 

  36. Varadarajan KM, Zumbrunn T, Rubash HE, Malchau H, Li G, Muratoglu OK (2015) Cruciate retaining implant with biomimetic articular surface to reproduce activity dependent kinematics of the normal knee. J Arthroplasty 30:2149–2153.e2142

    Article  Google Scholar 

  37. Walker T, Heinemann P, Bruckner T, Streit MR, Kinkel S, Gotterbarm T (2017) The influence of different sets of surgical instrumentation in Oxford UKA on bearing size and component position. Arch Orthop Trauma Surg 137:895–902

    Article  Google Scholar 

  38. Wiik AV, Aqil A, Tankard S, Amis AA, Cobb JP (2015) Downhill walking gait pattern discriminates between types of knee arthroplasty: improved physiological knee functionality in UKA versus TKA. Knee Surg Sports Traumatol Arthrosc 23:1748–1755

    Article  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Author notes

  1. Yong-Gon Koh and Jin-Ah Lee contributed equally to this work and should be considered cofirst authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul, 06698, South Korea

    Yong-Gon Koh

  2. Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Jin-Ah Lee, Hwa-Yong Lee, Heoung-Jae Chun & Kyoung-Tak Kang

  3. Department of Sport and Healthy Aging, Korea National Sport University, 1239 Yangjae-dearo, Songpa-gu, Seoul, 05541, South Korea

    Hyo-Jeong Kim

Authors
  1. Yong-Gon Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jin-Ah Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hwa-Yong Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heoung-Jae Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hyo-Jeong Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyoung-Tak Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyoung-Tak Kang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval was not required, as neither human participants nor animals were involved in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Koh, YG., Lee, JA., Lee, HY. et al. Anatomy-mimetic design preserves natural kinematics of knee joint in patient-specific mobile-bearing unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 28, 1465–1472 (2020). https://doi.org/10.1007/s00167-019-05540-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-019-05540-0

Keywords

Search

Navigation