title: Continuous sagittal radiological evaluation of stair-climbing in cruciate-retaining and posterior-stabilized total knee arthroplasties using image-matching techniques.
abstract: In this study, we evaluated the in vivo kinematics of stair-climbing after posterior stabilized (PS) and cruciate retaining (CR) total knee arthroplasty (TKA) using radiographic-based image-matching techniques. Mid-flexion anteroposterior stability was demonstrated in all knees after CR TKA. However, paradoxical femoral translation at low flexion angles was seen in both designs. The post-cam mechanism did not function after PS TKA. Larger posterior tibial slope in PS TKA was linked to forward sliding of the femur at mid-flexion and unintended anterior tibial post impingement at knee extension. CR TKA is more sagittally stable in mid-flexion during stair climbing and attention must be given to minimize posterior tibial slope when using late cam-post engaging PS TKA designs.
authors.affiliation: Department of Artificial Joints and Biomaterials, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamai
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okazaki
authors.affiliation: Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimoto
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakahara
authors.affiliation: Department of Mechanical Engineering, Faculty of Engineering, Kyushu Sangyo University, Fukuoka, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Higaki
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005269:Femur / Q000601:surgery; D005684:Gait / Q000502:physiology*; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular
keywords: kinematics; post-cam mechanism; posterior cruciate ligament; stair-climbing; total knee arthroplasty