title: Cruciate Retaining Implant With Biomimetic Articular Surface to Reproduce Activity Dependent Kinematics of the Normal Knee.
abstract: Alterations in normal knee kinematics following total knee arthroplasty (TKA) arise in part from the non-anatomic articular geometry of contemporary implants. In this study, the kinematics of a novel posterior cruciate-retaining (CR) implant with anatomic (biomimetic) articular surface, were compared to that of contemporary CR implants during various simulated activities. Across different simulated activities the biomimetic-CR mimicked normal kinematic patterns more closely than contemporary CR implants. In particular, during deep knee bend and chair-sit, the biomimetic-CR showed medial pivot motion, while other CR implants showed abnormal motion including lateral pivot or no pivot, and paradoxical anterior sliding. Further in vivo and clinical studies are needed to determine whether such biomimetic implants can truly help to achieve a more normal feeling knee and improved patient satisfaction.
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Kartik Mangudi M
authors.initials: KM
authors.lastname: Varadarajan
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zumbrunn
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Harry E
authors.initials: HE
authors.lastname: Rubash
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.affiliation: Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Guoan
authors.initials: G
authors.lastname: Li
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Orhun K
authors.initials: OK
authors.lastname: Muratoglu
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D032701:Biomimetics; D003198:Computer Simulation; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008954:Models, Biological; D017060:Patient Satisfaction; D016059:Range of Motion, Articular
keywords: Total knee arthroplasty; biomimetic; cruciate retaining; implant design; knee kinematics; normal function