Tibiofemoral kinematic analysis of kneeling after total knee arthroplasty.
Some surgeons warn against kneeling after total knee arthroplasty (TKA), because limited clinical data exist. We describe the tibiofemoral contact position of TKA components during kneeling in vivo. Ten posterior-substituting (PS) and 10 cruciate-retaining (CR) designs were examined using a radiographic image-matching technique. Movement from standing to kneeling at 90 degrees produced different responses. CR knees translated anteriorly (medial, 4 +/- 4 mm; lateral, 2 +/- 6 mm). PS knees underwent little posterior translation (medial, 0.2 +/- 3 mm; lateral, 1 +/- 4 mm). Movement from 90 degrees to maximum flexion produced femoral posterior translation (CR medial, 5 +/- 4 mm; CR lateral, 5 +/- 4 mm; PS medial, 6 +/- 4 mm; PS lateral, 6 +/- 3 mm). The relationship between tibiofemoral contact position and flexion angle was more variable for CR (r2=.38) than for PS (r2=.64). Knee kinematics was similar to other deep-flexion weight-bearing activities.
Department of Orthopaedics and Rehabilitation, McClure Musculoskeletal Research Center, University of Vermont, Burlington 05405-0084, USA.
Stephen J
SJ
Incavo
Eric R
ER
Mullins
Kathryn M
KM
Coughlin
Scott
S
Banks
Anne
A
Banks
Bruce D
BD
Beynnon
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D005260:Female; D005269:Femur / Q000502:physiology* / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D013977:Tibia / Q000502:physiology* / Q000503:physiopathology; D016474:Weight-Bearing / Q000502:physiology