title: Articular contact kinematics of the knee before and after a cruciate retaining total knee arthroplasty.
abstract: Accurate knowledge of tibiofemoral articular contact kinematics of the knee after total knee arthroplasty (TKA) is important for understanding the intrinsic knee biomechanics and improving the longevity of the components. The objective of this study was to compare the in vivo articular contact kinematics of the knees with end-stage medial osteoarthritis (OA) during a weight-bearing, single leg lunge activity before and after a posterior cruciate retaining TKA (CR-TKA) using a dual fluoroscopic imaging technique. We found that the CR-TKA resulted in more posterior contact positions on the tibial surface and a reduced range of motion in the medial and lateral compartments. The distances between medial and lateral contact locations in the CR-TKA knees were statistically larger than the OA knees. The articular contact centers have shifted from medial side of the tibial plateau pre-operatively to the lateral side after operation. This study indicated that the CR-TKA resulted in significant changes in contact kinematics of the knees in both anteroposterior and mediolateral directions. Further studies are needed to determine the influence of the altered in vivo contact kinematics on the longevity of polyethylene liner and long term clinical outcomes of the TKA.
authors.affiliation: Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, Massachusetts 02114; Department of Orthopaedic Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 1000853, China.
authors.forename: Chunbao
authors.initials: C
authors.lastname: Li
authors.forename: Ali
authors.initials: A
authors.lastname: Hosseini
authors.forename: Tsung-Yuan
authors.initials: TY
authors.lastname: Tsai
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kwon
authors.forename: Guoan
authors.initials: G
authors.lastname: Li
mesh_terms: D000368:Aged; D016118:Anterior Cruciate Ligament / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*
keywords: TKA; contact kinematics; fluoroscopy; in vivo kinematics; knee osteoarthritis