title: Regaining Native Knee Kinematics Following Joint Arthroplasty: A Novel Biomimetic Design with ACL and PCL Preservation.
abstract: Lack of ACL and non-anatomic articular surfaces in contemporary total knee implants result in kinematic abnormalities. We hypothesized that such abnormalities may be addressed with a biomimetic bi-cruciate retaining (BCR) design having anatomical articular surfaces. We used dynamic computer simulations to compare kinematics among the biomimetic BCR, a contemporary BCR and cruciate-retaining implant for activities of daily living. During simulated deep knee bend, chair-sit and walking, the biomimetic BCR implant showed activity dependent kinematics similar to healthy knees in vivo. Restoring native knee geometry together with ACL preservation provided these kinematic improvements over contemporary ACL-preserving and ACL-sacrificing implants. Further clinical studies are required to determine if such biomimetic implants can result in more normal feeling knees and improve quality of life for active patients.
authors.affiliation: Technology Implementation Research Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts; Department of Health Sciences and Technology, ETH Zürich (Swiss Federal Institute of Technology), Zurich, Switzerland.
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: Kartik Mangudi
authors.initials: KM
authors.lastname: Varadarajan
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: D000203:Activities of Daily Living; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000502:physiology*; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D032701:Biomimetics; D003198:Computer Simulation; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D007720:Knee Prosthesis / Q000706:statistics & numerical data*; D008297:Male; D008954:Models, Biological; D016119:Posterior Cruciate Ligament / Q000502:physiology; D011474:Prosthesis Design / Q000706:statistics & numerical data*; D011788:Quality of Life; D016059:Range of Motion, Articular; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: ACL preservation; BCR implant design; biomimetic; dynamic simulations; kinematics; total knee arthroplasty