Differences in knee joint kinematics and forces after posterior cruciate retaining and stabilized total knee arthroplasty

被引:48
作者
Wuenschel, Markus [1 ]
Leasure, Jeremi M. [2 ]
Dalheimer, Philipp [1 ]
Kraft, Nicole [1 ]
Wuelker, Nikolaus [1 ]
Mueller, Otto [1 ]
机构
[1] Univ Tubingen Hosp, Dept Orthopaed Surg, D-72076 Tubingen, Germany
[2] Taylor Labs, San Francisco, CA 94117 USA
关键词
Kinematics; Forces; Knee joint; Robotics; Arthroplasty; WEIGHT-BEARING FLEXION; IN-VIVO KINEMATICS; SITU FORCES; LIGAMENT; VITRO; ANTERIOR; PROSTHESIS; LOAD; SUBSTITUTION; RETENTION;
D O I
10.1016/j.knee.2013.03.005
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background: Posterior cruciate ligament (PCL) retaining (CR) and -sacrificing (PS) total knee arthroplasties (TKA) are widely-used to treat osteoarthritis of the knee joint. The PS design substitutes the function of the PCL with a cam-spine mechanism which may produce adverse changes to joint kinematics and kinetics. Methods: CR- and PS-TKA were performed on 11 human knee specimens. joint kinematics were measured with a dynamic knee simulator and motion tracking equipment. In-situ loads of the PCL and cam-spine were measured with a robotic force sensor system. Partial weight bearing flexions were simulated and external forces were applied. Results: The PS-TKA rotated significantly less throughout the whole flexion range compared to the CR-TKA. Femoral roll back was greater in the PS-TKA; however, this was not correlated with lower quadriceps forces. Application of external loads produced significantly different in-situ force profiles between the TKA systems. Conclusions: Our data demonstrate that the PS-design significantly alters kinematics of the knee joint Our data also suggest the cam-spine mechanism may have little influence on high flexion kinematics (such as femoral rollback) with most of the load burden shared by supporting implant and soft-tissue structures. (C) 2013 Elsevier B.V. All rights reserved.
引用
收藏
页码:416 / 421
页数:6
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