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No difference in patellar kinematics between fixed-bearing cruciate-retaining and cruciate-substituting total knee arthroplasty: a cadaveric investigation

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Abstract

Purpose

The influence of cruciate-ligament-retaining (CR-TKA) and cruciate-ligament-substituting (CS-TKA) TKA on tibiofemoral kinematics was analysed in many investigations. However, the influence on patellar kinematics is unclear so far. The aim of this study was to compare patellar kinematics of the natural knee with those after CR- and CS-TKA.

Methods

Patellar kinematics of nine healthy whole-body cadaveric knees before and after CR- and CS-TKA was investigated using a commercial optical computer navigation system. Patellar kinematics of the healthy knee was compared with those after CR- and CS-TKA.

Results

No significant difference between the natural knee and the knee after TKA or between both types of TKA for patellar kinematics could be found. Interestingly, both types of TKA resulted in a more medial patellar shift and a contrary patellar tilt and rotation behaviour. CR- and CS-TKA resulted in smaller values for patellar epicondylar distance at all flexion angles.

Conclusions

Our study found no influence of prosthesis type on patellar kinematics. Factors like component alignment and prosthesis design seem to be more important in terms of adequate restoration of patellar kinematics in TKA than whether choosing CR- or CS-TKA.

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Acknowledgments

We to thank DePuy, Germany and Brainlab, Germany for technical and logistical support for this study. Furthermore, we thank the Institute of Anatomy at the Medical University of Graz/Austria, for providing the specimen for this investigation.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany

    Armin Keshmiri, Günther Maderbacher, Achim Benditz, Joachim Grifka & Benjamin Craiovan

  2. Department of Orthopaedic Surgery, Cantonal Hospital Bruderholz, 4101, Bruderholz, Switzerland

    Werner Müller

Authors
  1. Armin Keshmiri
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  2. Günther Maderbacher
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  3. Achim Benditz
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  4. Werner Müller
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  5. Joachim Grifka
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  6. Benjamin Craiovan
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Corresponding author

Correspondence to Armin Keshmiri.

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Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Additional information

This work was performed at the Department of Orthopedic Surgery at the Medical University of Regensbur/Germany.

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Keshmiri, A., Maderbacher, G., Benditz, A. et al. No difference in patellar kinematics between fixed-bearing cruciate-retaining and cruciate-substituting total knee arthroplasty: a cadaveric investigation. International Orthopaedics (SICOT) 40, 731–735 (2016). https://doi.org/10.1007/s00264-015-3041-y

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  • DOI: https://doi.org/10.1007/s00264-015-3041-y

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