Clinical Orthopaedics and Related Research®

, Volume 468, Issue 3, pp 807–814 | Cite as

In Vivo Kinematics after a Cruciate-substituting TKA

  • Jan Victor
  • John Kyle P. Mueller
  • Richard D. Komistek
  • Adrija Sharma
  • Matthew C. Nadaud
  • Johan Bellemans
Clinical Research

Abstract

Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Three-dimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was −14.0 mm and −23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8°. The average weightbearing range of motion (ROM) was 109º (range, 60º–150º; standard deviation, 18.7º). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Supplementary material

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Supplementary material 1 (AVI 15646 kb)
11999_2009_1072_MOESM2_ESM.avi (11.4 mb)
Supplementary material 2 (AVI 11686 kb)

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Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Jan Victor
    • 1
  • John Kyle P. Mueller
    • 2
  • Richard D. Komistek
    • 2
  • Adrija Sharma
    • 2
  • Matthew C. Nadaud
    • 3
  • Johan Bellemans
    • 4
  1. 1.AZ St-Lucas, St-LucaslaanBruggeBelgium
  2. 2.Center for Musculoskeletal ResearchUniversity of Tennessee-KnoxvilleKnoxvilleUSA
  3. 3.Knoxville Orthopaedic ClinicKnoxvilleUSA
  4. 4.UZ LeuvenLeuvenBelgium

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