title: Factors in high-flex posterior stabilized fixed-bearing total knee arthroplasty affecting in vivo kinematics and anterior tibial post impingement during gait.
abstract: One of the most important issues in high-flex posterior stabilized total knee arthroplasty (TKA) is anterior tibial post impingement. We examined 20 knees and 2 TKA designs to evaluate the in vivo kinematics during gait using fluoroscopic image analysis. The AP positions in both stance and swing phases were significantly larger and more anterior in J-curved design TKA compared with Single radius design TKA. Anterior tibial post impingement was observed in five knees implanted with Legacy-flex, and in four of the five knees they were not hyperextended. No impingement was observed with NRG. Less constraint and tibial posterior slope might lead to large AP translations and anterior tibial post impingement. Implant design and operative procedures for high-flexion TKAs affect the in vivo kinematics and the occurrence of anterior tibial post impingement.
authors: Department of Orthopaedic Surgery, Osaka National Hospital.
authors: Masashi
authors: M
authors: Tamaki
authors: Tetsuya
authors: T
authors: Tomita
authors: Takaharu
authors: T
authors: Yamazaki
authors: Hideki
authors: H
authors: Yoshikawa
authors: Kazuomi
authors: K
authors: Sugamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005471:Fluoroscopy; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D013977:Tibia / Q000601:surgery
keywords: Fluoroscopy; Gait; Impingement; Total knee arthroplasty