Abstract
Knee forces directly affect arthroplasty component survivorship, wear of articular bearing surfaces, and integrity of the bone-implant interface. It is not known which activities generate forces within a range that is physiologically desirable but not high enough to jeopardize the survivorship of the prosthetic components. We implanted three patients with an instrumented tibial prosthesis and measured knee forces and moments in vivo during exercise and recreational activities. As expected, stationary bicycling generated low tibial forces, whereas jogging and tennis generated high peak forces. On the other hand, the golf swing generated unexpectedly high forces, especially in the leading knee. Exercise on the elliptical trainer generated lower forces than jogging but not lower than treadmill walking. These novel data allow for a more scientific approach to recommending activities after TKA. In addition, these data can be used to develop clinically relevant structural and tribologic testing, which may result in activity-specific knee designs such as a knee design more tolerant of golfing by optimizing the conflicting needs of increased rotational laxity and conformity.
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Acknowledgments
We thank Juan Hermida, MD, for his contribution to the in vitro testing of the implants, Zachary Dooley, MS, for assistance with data collection and analysis, and Judy Blake for manuscript formatting and copyediting.
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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
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D’Lima, D.D., Steklov, N., Patil, S. et al. The Mark Coventry Award: In Vivo Knee Forces During Recreation and Exercise After Knee Arthroplasty. Clin Orthop Relat Res 466, 2605–2611 (2008). https://doi.org/10.1007/s11999-008-0345-x
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DOI: https://doi.org/10.1007/s11999-008-0345-x