Kinematics of medial osteoarthritic knees before and after posterior cruciate ligament retaining total knee arthroplasty.
Total knee arthroplasty (TKA) is a widely accepted surgical procedure for the treatment of patients with end-stage osteoarthritis (OA). However, the function of the knee is not always fully recovered after TKA. We used a dual fluoroscopic imaging system to evaluate the in vivo kinematics of the knee with medial compartment OA before and after a posterior cruciate ligament-retaining TKA (PCR-TKA) during weight-bearing knee flexion, and compared the results to those of normal knees. The OA knees displayed similar internal/external tibial rotation to normal knees. However, the OA knees had less overall posterior femoral translation relative to the tibia between 0° and 105° flexion and more varus knee rotation between 0° and 45° flexion, than in the normal knees. Additionally, in the OA knees the femur was located more medially than in the normal knees, particularly between 30° and 60° flexion. After PCR-TKA, the knee kinematics were not restored to normal. The overall internal tibial rotation and posterior femoral translation between 0° and 105° knee flexion were dramatically reduced. Additionally, PCR-TKA introduced an abnormal anterior femoral translation during early knee flexion, and the femur was located lateral to the tibia throughout weight-bearing flexion. The data help understand the biomechanical functions of the knee with medial compartment OA before and after contemporary PCR-TKA. They may also be useful for improvement of future prostheses designs and surgical techniques in treatment of knees with end-stage OA.
Yue
Bing
B
Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, GRJ 1215, Boston, Massachusetts 02114, USA.
Varadarajan
Kartik M
KM
Moynihan
Angela L
AL
Liu
Fang
F
Rubash
Harry E
HE
Li
Guoan
G
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000601:surgery*