Kinematically aligned total knee arthroplasty limits high tibial forces, differences in tibial forces between compartments, and abnormal tibial contact kinematics during passive flexion

Accurate knowledge of in vivo articular contact kinematics and contact forces is required to quantitatively understand factors limiting life of total knee arthroplasty (TKA) implants, such as polyethylene component wear and implant loosening [1]. Determination of in vivo tibiofemoral contact forces has been a challenging issue in biomechanics. Historically, instrumented tibial implants have been used to measure tibiofemoral forces in vitro [2] and computational models involving inverse dynamic optimization have been used to estimate joint forces in vivo [3]. Recently, D’Lima et al. reported the first in vivo measurement of 6DOF tibiofemoral forces via an instrumented implant in a TKA patient [4]. However this technique does not provide a direct estimation of tibiofemoral contact forces in the medial and lateral compartments. Recently, a dual fluoroscopic imaging system has been used to accurately determine tibiofemoral contact locations on the medial and lateral tibial polyethylene surfaces [5]. The objective of this study was to combine the dual fluoroscope technique and the instrumented TKAs to determine the dynamic 3D articular contact kinematics and contact forces on the medial and lateral tibial polyethylene surfaces during functional activities.

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Gravity-Assisted Passive Flexion in Total Knee Arthroplasty Recovery

Orthopedics ◽

10.3928/01477447-20200721-09 ◽

2020 ◽

Vol 43 (5) ◽

pp. e431-e437

Author(s):

Frank A. Buttacavoli

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Passive Flexion ◽

Total Knee

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In vivo contact kinematics and contact forces of the knee after total knee arthroplasty during dynamic weight-bearing activities

Journal of Biomechanics ◽

10.1016/j.jbiomech.2008.04.021 ◽

2008 ◽

Vol 41 (10) ◽

pp. 2159-2168 ◽

Cited By ~ 59

Author(s):

Kartik M. Varadarajan ◽

Angela L. Moynihan ◽

Darryl D’Lima ◽

Clifford W. Colwell ◽

Guoan Li

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Weight Bearing ◽

Contact Forces ◽

Dynamic Weight ◽

Contact Kinematics ◽

Total Knee

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Bi‐Cruciate Retaining Total Knee Arthroplasty Does Not Restore Native Tibiofemoral Articular Contact Kinematics During Gait

Journal of Orthopaedic Research® ◽

10.1002/jor.24333 ◽

2019 ◽

Vol 37 (9) ◽

pp. 1929-1937 ◽

Cited By ~ 9

Author(s):

Tsung‐Yuan Tsai ◽

Ming Han Lincoln Liow ◽

Guoan Li ◽

Paul Arauz ◽

Yun Peng ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Cruciate Retaining ◽

Contact Kinematics ◽

Total Knee

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An Improved Tibial Force Sensor to Compute Contact Forces and Contact Locations In Vitro After Total Knee Arthroplasty

Journal of Biomechanical Engineering ◽

10.1115/1.4035471 ◽

2017 ◽

Vol 139 (4) ◽

Cited By ~ 9

Author(s):

Joshua D. Roth ◽

Stephen M. Howell ◽

Maury L. Hull

Keyword(s):

Total Knee Arthroplasty ◽

Contact Force ◽

Knee Arthroplasty ◽

Force Sensor ◽

Contact Forces ◽

Contact Kinematics ◽

Tibial Insert ◽

Total Knee ◽

Mean Square Errors

Contact force imbalance and contact kinematics (i.e., motion of the contact location in each compartment during flexion) of the tibiofemoral joint are both important predictors of a patient's outcome following total knee arthroplasty (TKA). Previous tibial force sensors have limitations in that they either did not determine contact forces and contact locations independently in the medial and lateral compartments or only did so within restricted areas of the tibial insert, which prevented them from thoroughly evaluating contact force imbalance and contact kinematics in vitro. Accordingly, the primary objective of this study was to present the design and verification of an improved tibial force sensor which overcomes these limitations. The improved tibial force sensor consists of a modified tibial baseplate which houses independent medial and lateral arrays of three custom tension–compression transducers each. This sensor is interchangeable with a standard tibial component because it accommodates tibial articular surface inserts with a range of sizes and thicknesses. This sensor was verified by applying known loads at known locations over the entire surface of the tibial insert to determine the errors in the computed contact force and contact location in each compartment. The root-mean-square errors (RMSEs) in contact force are ≤ 6.1 N which is 1.4% of the 450 N full-scale output. The RMSEs in contact location are ≤ 1.6 mm. This improved tibial force sensor overcomes the limitations of the previous sensors and therefore should be useful for in vitro evaluation of new alignment goals, new surgical techniques, and new component designs in TKA.

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