title: Influence of bi- and tri-compartmental knee arthroplasty on the kinematics of the knee joint.
abstract: BACKGROUND
  The cruciate ligaments are important stabilizers of the knee joint and determine joint kinematics in the natural knee and after cruciate retaining arthroplasty.No in vitro data is available to biomechanically evaluate the ability of the anterior cruciate ligament (ACL) to maintain knee joint kinematics after bicruciate-retaining bi-compartmental knee arthroplasty (BKA).Therefore, the objective of the current study was to investigate the kinematics of the natural knee joint, before and after installing bicruciate-retaining BKA and posterior cruciate retaining total knee arthroplasty. Specifically, we incorporated a dynamic knee simulator to simulate weight-bearing flexions on cadaveric knee specimen before and after surgical manipulations.
  
  
  METHODS
  In this cadaveric study we investigated rotational and translational tibiofemoral kinematics during simulated weight-bearing flexions of the intact knee, after bi-compartmental knee arthroplasty (BKA+), after resecting the ACL in BKA (BKA-), and after posterior cruciate retaining total knee arthroplasty (TKA).
  
  
  RESULTS
  Rotation of BKA+ is closest to the intact knee joint, whereas TKA shows significant differences from 30 to 90 degree of flexion. Within the tested flexion range (15 to 90 degree of flexion), there was no significant difference in the anterior-posterior translation among intact, BKA+, and TKA knees. Resecting the ACL in BKA leads to a significant anterior tibial translation.
  
  
  CONCLUSIONS
  BKA with intact cruciate ligaments resembles rotation and translation of the natural knee during a simulated weight-bearing flexion. It is a suitable treatment option for medial and patellofemoral osteoarthritis with advantages in rotational characteristics compared to TKA.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital Tübingen, Hoppe-Seyler-Str, 3, 72076 Tübingen, Germany. Markus.Wuenschel@med.uni-tuebingen.de
authors.forename: Markus
authors.initials: M
authors.lastname: Wünschel
authors.forename: Jiahsuan
authors.initials: J
authors.lastname: Lo
authors.forename: Torsten
authors.initials: T
authors.lastname: Dilger
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Wülker
authors.forename: Otto
authors.initials: O
authors.lastname: Müller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology