title: In vivo kinematics of a unique posterior-stabilized knee implant during a stepping exercise.
abstract: BACKGROUND
  Stair-stepping motion is important in daily living, similar to gait. Knee prostheses need to have even more superior performance and stability in stair-stepping motion than in gait. The purpose of this analysis was to estimate in vivo knee motion in stair stepping and determine if this unique knee prosthesis function as designed.
  
  
  METHODS
  A total of 20 patients with Bi-Surface posterior-stabilizing (PS) implants were assessed. The Bi-Surface PS knee is a posterior-cruciate substitute prosthesis with a unique ball-and-socket joint in the mid-posterior portion of the femoral and tibial components. Patients were examined during stair-stepping motion using a 2-dimensional to 3-dimensional registration technique.
  
  
  RESULTS
  The kinematic pattern in step up was a medial pivot, in which the level of anteroposterior translation was very small. In step down, the kinematic pattern was neither a pivot shift nor a rollback. From minimum to maximum flexion, anterior femoral translation occurred slightly.
  
  
  CONCLUSIONS
  In this study, this unique implant had good joint stability during stair stepping. The joint's stability during stair stepping was affected by the design of the femorotibial joint rather than post/cam engagement or the ball-and-socket joint.
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1 ChofuUshiroda Simonoseki, Yamaguchi, 752-8510, Japan. minet@kanmon-mc2.hosp.go.jp.
authors.forename: Takatomo
authors.initials: T
authors.lastname: Mine
authors.affiliation: Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hoshi
authors.affiliation: Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Gamada
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1 ChofuUshiroda Simonoseki, Yamaguchi, 752-8510, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ihara
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1 ChofuUshiroda Simonoseki, Yamaguchi, 752-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawamura
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1 ChofuUshiroda Simonoseki, Yamaguchi, 752-8510, Japan.
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Kuriyama
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1 ChofuUshiroda Simonoseki, Yamaguchi, 752-8510, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Date
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D007720:Knee Prosthesis; D008124:Locomotion / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology*
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