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Confirmation of Long-term In Vivo Bearing Mobility in Eight Rotating-platform TKAs

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Posterior-stabilized rotating-platform prostheses for TKAs were designed to improve contact mechanics at the femoral-polyethylene (PE) interface. Short-term followup studies have shown that the PE bearings rotate with respect to the tibia but might not necessarily track with the femur. It is important to know how kinematics in these designs change owing to long-term in vivo use.

Questions/purposes

We asked whether there is a significant change in the in vivo kinematic performance of a posterior-stabilized rotating-platform prosthesis at as much as 10 years postoperative. We specifically examined (1) relative femoral component-PE bearing and relative PE bearing-tibial tray motion; (2) relative AP motion of the femoral condyles with respect to the tibial tray; and (3) relative femorotibial condylar translations.

Methods

In vivo three-dimensional kinematics were evaluated for eight patients at 3 months, 15 months, 5 years, and 10 years after TKA with primary implantation of a posterior-stabilized rotating-platform prosthesis. Each patient performed deep knee bend activity, and three-dimensional kinematics were reconstructed from multiple fluoroscopic images using a three-dimensional to two-dimensional registration technique. Once complete, relative component axial rotation patterns, medial and lateral condyle motions throughout flexion, and the presence of femoral condylar lift-off were analyzed.

Results

Overall, tibial bearing rotation was maintained at 10 years postoperatively. There was no statistical difference between postoperative periods for any kinematic parameter except for femoral component-PE bearing axial rotation, which was reduced at the 10-year evaluation versus other assessment periods (p = 0.0006). The lack of statistical difference between postoperative evaluation periods indicates sustained overall implant kinematic performance.

Conclusions

Our study showed that PE bearing-tibial tray mobility was maintained and that femoral component-PE bearing rotation was reduced at the 10-year followup. This suggests that the overall kinematic performance of this mobile-bearing implant is not negatively affected 10 years postoperatively.

Level of Evidence

Level III, retrospective study. See the Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Mathew Anderle BS, Center for Musculoskeletal Research, University of Tennessee (Knoxville, TN, USA), for his invaluable help in collecting and analyzing the data.

Author information

Authors and Affiliations

  1. Center for Musculoskeletal Research, University of Tennessee, 311 Perkins Hall, Knoxville, TN, 37996, USA

    Michael T. LaCour BS, Adrija Sharma PhD, Christopher B. Carr PhD & Richard D. Komistek PhD

  2. Colorado Joint Replacement, Denver, CO, USA

    Douglas A. Dennis MD

  3. Department of Biomedical Engineering, University of Tennessee, Knoxville, TN, USA

    Douglas A. Dennis MD

  4. The University of Colorado Health Sciences Center, Denver, CO, USA

    Douglas A. Dennis MD

  5. Rocky Mountain Musculoskeletal Research Laboratory, Denver, CO, USA

    Douglas A. Dennis MD

Authors
  1. Michael T. LaCour BS
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  2. Adrija Sharma PhD
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  3. Christopher B. Carr PhD
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  4. Richard D. Komistek PhD
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  5. Douglas A. Dennis MD
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Corresponding author

Correspondence to Adrija Sharma PhD.

Additional information

One of the authors (RDK) certifies that he or a member of his immediate family has or may receive payments or benefits during this study period of an amount of USD 100,001 to USD 1,000,000 from DePuy Synthes Inc (Warsaw, IN, USA). One of the authors (DAD) certifies that he or a member of his immediate family has or may receive payments or benefits during this study period of an amount of more than USD 100,001 from DePuy Synthes Inc.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his institution approved the human protocols for these previous studies, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation was also obtained.

This work was performed at the University of Tennessee, Knoxville, TN, USA.

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LaCour, M.T., Sharma, A., Carr, C.B. et al. Confirmation of Long-term In Vivo Bearing Mobility in Eight Rotating-platform TKAs. Clin Orthop Relat Res 472, 2766–2773 (2014). https://doi.org/10.1007/s11999-014-3642-6

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  • DOI: https://doi.org/10.1007/s11999-014-3642-6

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