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Kinematic analysis of mobile-bearing total knee arthroplasty using a 6-DOF knee simulator

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The purpose of this study was to investigate the kinematics of the polyethylene insert in two designs of mobilebearing total knee arthroplasty, using a six-degrees-of-freedom knee simulator. It was consequently not clear whether the motion of the polyethylene bearing in mobile-bearing total knee arthroplasty could be demonstrated during the gait cycle or more rapid movement.

Methods

A mobile-bearing knee (Zimmer) and a low contact stress rotating-platform design (Depuy) were mounted on a simulator which was regulated by the kinematic data of gait. The simulating test was conducted under a static condition as well as under dynamic conditions of 0.5 Hz and 1.0 Hz. We recorded the motions of the implants with two charge-coupled device (CCD) cameras, and the positions of the insert were calculated.

Results

In spite of the same relative motion between the femoral component and the tibial tray, the polyethylene insert showed unique relative motion according to the given condition. The motion of the insert during the dynamic conditions was considerably decreased in comparison to the static condition in both mobile-bearing designs. In addition, the insert showed a smaller amplitude and frequency of rotations under increasing speed in the low contact stress rotating-platform design. The low contact stress rotating-platform design showed a larger amplitude and frequency of rotations than the mobilebearing knee.

Conclusions

Despite the mobility of the insert in the mobilebearing total knee arthroplasty, the motion of the insert was decreased during dynamic conditions because of the disruption of full contact between the femoral component and the polyethylene insert. Differences in the rotation between the mobile-bearing knee and the low contact stress rotatingplatform design were due to the fixed axis of the internalexternal rotation in the low contact stress rotating-platform design. The theoretical advantages for the mobile-bearing design over the fixed-bearing design were not demonstrated in this study.

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References

  1. Kaper BP, Smith PN, Bourne RB, Rorabeck CH, Robertson D. Medium-term results of a mobile bearing total knee replacement. Clin Orthop 1999;367:201–209.

    PubMed  Google Scholar 

  2. Sánchez-Sotelo J, Ordoñez JM, Prats SB. Results and complications of the low contact stress knee prosthesis. J Arthroplasty 1999;14:815–821.

    Article  PubMed  Google Scholar 

  3. Callaghan JJ, Squire MW, Goetz DD, Sullivan PM, Johnston RC. Cemented rotating-platform total knee replacement. A 9- to 12-year follow-up study. J Bone Joint Surg Am 2000;82:705–711.

    Article  PubMed  CAS  Google Scholar 

  4. Price AJ, Rees JL, Beard D, Juszczak E, Carter S, White S, et al. A mobile-bearing total knee prosthesis compared with a fixedbearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br 2003;85:62–67.

    Article  PubMed  CAS  Google Scholar 

  5. Sorrells RB, Voorhorst PE, Murphy JA, Bauschka MP, Greenwald AS. Uncemented rotating-platform total knee replacement: a 5- to 12-year follow-up study. J Bone Joint Surg Am 2004;86:2156–2162.

    PubMed  Google Scholar 

  6. Huang CH, Ma HM, Liau JJ, Ho FY, Cheng CK. Osteolysis in failed total knee arthroplasty: a comparison of mobile-bearing and fixed-bearing knees. J Bone Joint Surg Am 2002;84:2224–2229.

    PubMed  Google Scholar 

  7. Huang CH, Ma HM, Lee YM, Ho FY. Long-term results of low contact stress mobile-bearing total knee replacements. Clin Orthop 2003;416:265–270.

    Article  PubMed  Google Scholar 

  8. Aglietti P, Baldini A, Buzzi R, Lup D, De Luca L. Comparison of mobile-bearing and fixed-bearing total knee arthroplasty: a prospective randomized study. J Arthroplasty 2005;20:145–153.

    Article  PubMed  Google Scholar 

  9. Chiu KY, Ng TP, Tang WM, Lam P. Bilateral total knee arthroplasty: one mobile-bearing and one fixed-bearing. J Orthop Surg (Hong Kong) 2001;9:45–50.

    Google Scholar 

  10. Kim YH, Kook HK, Kim JS. Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop 2001; 392:101–115.

    Article  PubMed  Google Scholar 

  11. Bhan S, Malhotra R, Kiran EK, Shukla S, Bijjawara M. A comparison of fixed-bearing and mobile-bearing total knee arthroplasty at a minimum follow-up of 4.5 years. J Bone Joint Surg Am 2005;87:2290–2296.

    Article  PubMed  CAS  Google Scholar 

  12. Haas BD, Komistek RD, Stiehl JB, Anderson DT, Northcut EJ. Kinematic comparison of posterior cruciate sacrifice versus substitution in a mobile bearing total knee arthroplasty. J Arthroplasty 2002;17:685–692.

    Article  PubMed  Google Scholar 

  13. Stiehl JB, Dennis DA, Komistek RD, Crane HS. In vivo determination of condylar lift-off and screw-home in a mobile-bearing total knee arthroplasty. J Arthroplasty 1999;14:293–299.

    Article  PubMed  CAS  Google Scholar 

  14. Sugita T, Sato K, Komistek RD, Mahfouz MR, Maeda I, Sano T. In vivo determination of knee kinematics for Japanese subjects having either a low contact stress rotating platform or an anteroposterior glide total knee arthroplasty. J Arthroplasty 2005;20:154–161.

    Article  PubMed  Google Scholar 

  15. Ranawat CS, Komistek RD, Rodriguez JA, Dennis DA, Anderle M. In vivo kinematics for fixed and mobile-bearing posterior stabilized knee prostheses. Clin Orthop 2004;418:184–190.

    Article  PubMed  Google Scholar 

  16. Rees JL, Beard DJ, Price AJ, Gill HS, McLardy-Smith P, Dodd CA, et al. Real in vivo kinematic differences between mobilebearing and fixed-bearing total knee arthroplasties. Clin Orthop 2005;432:204–209.

    PubMed  Google Scholar 

  17. Walker PS, Komistek RD, Barrett DS, Anderson D, Dennis DA, Sampson M. Motion of a mobile bearing knee allowing translation and rotation. J Arthroplasty 2002;17:11–19.

    Article  PubMed  Google Scholar 

  18. Nakayama K, Matsuda S, Miura H, Higaki H, Otsuka K, Iwamoto Y. Contact stress at the post-cam mechanism in posterior-stabilised total knee arthroplasty. J Bone Joint Surg Br 2005;87:483–488.

    PubMed  CAS  Google Scholar 

  19. Andriacchi TP, Alexander EJ, Toney MK, Dyrby C, Sum J. A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J Biomech Eng 1998;120:743–749.

    Article  PubMed  CAS  Google Scholar 

  20. Morrison JB. Bioengineering analysis of force actions transmitted by the knee joint. Biomed Eng 1968;3:164–170.

    Google Scholar 

  21. D’Lima DD, Patil S, Steklov N, Slamin JE, Colwell CW Jr. Tibial forces measured in vivo after total knee arthroplasty. J Arthroplasty 2006;21:255–262.

    Article  PubMed  Google Scholar 

  22. McGibbon CA, Krebs DE. Age-related changes in lower trunk coordination and energy transfer during gait. J Neurophysiol 2001;85:1923–1931.

    PubMed  CAS  Google Scholar 

  23. Borjesson M, Weidenhielm L, Mattsson E, Olsson E. Gait and clinical measurements in patients with knee osteoarthritis after surgery: a prospective 5-year follow-up study. Knee 2005;12:121–127.

    Article  PubMed  CAS  Google Scholar 

  24. Miura H, Higaki H, Nakanishi Y, Mawatari T, Moro-Oka T, Murakami T, et al. Prediction of total knee arthroplasty polyethylene wear using the wear index. J Arthroplasty 2002;17:760–766.

    Article  PubMed  Google Scholar 

  25. Kim JB, Brienza DM. Development of a remote accessibility assessment system through three-dimensional reconstruction technology. J Rehabil Res Dev 2006;43:257–272.

    Article  PubMed  Google Scholar 

  26. Bercovy M. Mobile-Bearing versus fixed-bearing knees. J Bone Joint Surg Am 2001;83:1113–1114.

    PubMed  Google Scholar 

  27. Callaghan JJ, Insall JN, Greenwald AS, Dennis DA, Komistek RD, Murray DW, et al. Mobile-bearing knee replacement: Concepts and results. J Bone Joint Surg Am 2000;82:1020–1041.

    Google Scholar 

  28. Komistek RD, Dennis DA, Mahfouz MR, Walker S, Outten J. In vivo polyethylene bearing mobility is maintained in posterior stabilized total knee arthroplasty. Clin Orthop 2004;428:207–213.

    Article  PubMed  Google Scholar 

  29. Dennis DA, Komistek RD, Mahfouz MR, Outten JT, Sharma A. Mobile-bearing total knee arthroplasty: do the polyethylene bearings rotate? Clin Orthop 2005;440:88–95.

    Article  PubMed  Google Scholar 

  30. Fantozzi S, Leardini A, Banks SA, Marcacci M, Giannini S, Catani F. Dynamic in-vivo tibio-femoral and bearing motions in mobile bearing knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2004;12:144–151.

    Article  PubMed  CAS  Google Scholar 

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Hamai, S., Miura, H., Higaki, H. et al. Kinematic analysis of mobile-bearing total knee arthroplasty using a 6-DOF knee simulator. J Orthop Sci 13, 543–549 (2008). https://doi.org/10.1007/s00776-008-1277-8

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  • DOI: https://doi.org/10.1007/s00776-008-1277-8

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