Gender Influences Gait Asymmetry following Bicruciate-Retaining Total Knee Arthroplasty

2019 ◽  
Vol 33 (06) ◽  
pp. 582-588 ◽  
Author(s):  
David Hennessy ◽  
Paul Arauz ◽  
Christian Klemt ◽  
Shuai An ◽  
Young-Min Kwon
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Imaging System ◽  
Knee Kinematics ◽  
Male And Female ◽  
Female Patients ◽  
Total Knee ◽  
Bcr Tka ◽  
Anterior Posterior

AbstractThis is an experimental study. Gender has been reported to influence outcomes in patients with total knee arthroplasty (TKA) for knee osteoarthritis (OA). However, the influence of gender on three-dimensional (3D) in vivo kinematics during gait remains unclear. This study aimed to determine if 3D gait kinematics, including 3D knee translations and rotations, differed in men and women following bicruciate-retaining (BCR) TKA. Twenty-nine well-functioning unilateral BCR TKA patients (14 males and 15 females) underwent evaluation of both knees during level walking on a treadmill at a self-selected speed using a dual fluoroscopic imaging system. Interlimb comparisons of in vivo 6 degree-of-freedom kinematics were compared between male and female patients. Differences of pre- and postoperative Knee Society scores (KSSs) were compared between the groups. Both groups were matched regarding age and body mass index. Both male and female patients demonstrated improvement in their postoperative KSSs. Statistically significant differences were observed with respect to spatiotemporal anterior–posterior interlimb translations (p < 0.05). Although females presented more femoral posterior translation in the operative knee than the nonoperative knee during most of the stance phases (2.8 vs. −1.6 mm), males exhibited less femoral translation in the operative knee than the nonoperative knee (2.3 vs. −1.8 mm), when interlimb differences were detected during stance phase. Results demonstrated that there are 3D motion asymmetries of the knee in both male and female unilateral BCR TKA patients during gait with anterior–posterior interlimb asymmetries significantly greater in female than male participants. This suggests that gender may influence the in vivo knee kinematics in BCR TKA patients during gait.

Effect of Gait on Patellofemoral Mechanics

2008 ◽  
Author(s):  
Jeffrey E. Bischoff ◽  
Justin S. Hertzler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Studies ◽  
Patellofemoral Joint ◽  
Knee Kinematics ◽  
Component Design ◽  
Total Knee ◽  
The Impact ◽  
Reconstructed Knee

Computational modeling of the reconstructed knee is an important tool in designing components for maximum functionality and life. Utilization of boundary conditions consistent with in vivo gait loading in such models enables predictions of knee kinematics and polyethylene damage [1–4], which can then be used to optimize component design. Several recent clinical studies have focused on complications associated with the patellofemoral joint [5–6], highlighting the need to better understand the mechanics of this compartment of total knee arthroplasty (TKA). This study utilizes a computational model to characterize the impact of gait loading on the mechanics of the patella in TKA.

In Vivo Tibiofemoral Contact Kinematics and Contact Forces During Dynamic Weight-Bearing Activities Following Total Knee Arthroplasty

2008 ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Angela Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Harry E. Rubash ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computational Models ◽  
Imaging System ◽  
Weight Bearing ◽  
Contact Forces ◽  
Inverse Dynamic ◽  
Contact Kinematics ◽  
Total Knee

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.

In Vivo Comparison of Knee Kinematics Before and After High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2010 ◽  
Vol 25 (6) ◽  
pp. 964-969 ◽  
Author(s):  
Atsushi Kitagawa ◽  
Nobuhiro Tsumura ◽  
Takaaki Chin ◽  
Kazuyoshi Gamada ◽  
Scott A. Banks ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Cruciate Retaining ◽  
High Flexion ◽  
Before And After ◽  
Total Knee

Knee kinematics after cruciate retaining highly congruent mobile bearing total knee arthroplasty: An in vivo dynamic RSA study

The Knee ◽  
2020 ◽  
Vol 27 (2) ◽  
pp. 341-347 ◽  
Author(s):  
Umberto Cardinale ◽  
Laura Bragonzoni ◽  
Marco Bontempi ◽  
Domenico Alesi ◽  
Tommaso Roberti di Sarsina ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Mobile Bearing ◽  
Cruciate Retaining ◽  
Total Knee

scholarly journals In vivo knee kinematics during high flexion after a posterior-substituting total knee arthroplasty

2009 ◽  
Vol 34 (4) ◽  
pp. 497-503 ◽  
Author(s):  
Angela L. Moynihan ◽  
Kartik M. Varadarajan ◽  
George R. Hanson ◽  
Sang-Eun Park ◽  
Kyung Wook Nha ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
High Flexion ◽  
Total Knee ◽  
In Vivo Knee Kinematics

scholarly journals In Vivo Kinematic Analysis of Bicruciate-retaining Total Knee Arthroplasty Focused on Function of the ACL

2021 ◽  
Author(s):  
Kosei Ishigaki ◽  
Hideyuki Aoki ◽  
Ryo Takamatsu ◽  
Yuji Nishiwaki ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Kinematic Analysis ◽  
Tibial Component ◽  
Lateral Translation ◽  
In Vivo Kinetics ◽  
Total Knee ◽  
Bcr Tka

Abstract Background: The utility of a bi-cruciate retaining total knee arthroplasty (BCR-TKA) is uncertain. In this study, we performed an in vivo kinematic analysis of squat motion on level ground and on a downward slope in patients treated with BCR-TKA to examine the value of anterior cruciate ligament (ACL) preservation.Methods: The subjects were ten valgus knees that underwent TKA (BCR: 5 knees, CR: 5 knees) at our hospital. We evaluated in vivo kinematics of the knee using fluoroscopy and investigated the femoral component translation relative to the tibial component from extension to maximum flexion, and the rotation angle between the components under the two conditions. Statistical analysis was conducted by Mann-Whitney U test to compare the rotational angle, the location of lateral and medial contact points per flexion angle. Differences in these parameters between the BCR and CR groups across the flexion angles were compared by repeated measures ANOVA.Results: Rotation of the femoral component to the tibial component occurred gradually as flexion continued. On level ground, lateral rotation at 0° to 120° flexion was 14.5±1.95° in the BCR group and 7.9±0.47° in the CR group. Medial translation was 4.1±1.73mm in the BCR group and 2.5±1.64mm in the CR group, and lateral translation was 13.2±1.6mm in the BCR group and 7.1±1.74mm in the CR group. On a forward slope, lateral rotation was 12.7±1.45° in the BCR group and 7.57±0.47° in the CR group. Medial translation was 5.87±1.78mm in the BCR and 2.9±0.81mm in the CR, and lateral translation was 13.6±1.84mm in the BCR and 7.4±0.96mm in the CR.Conclusion: An in vivo kinetics analysis of deep flexion motion was conducted on level ground and on a forward slope to stress the ACL. Under both conditions, kinetics close to screw home movement were found in the BCR group and rotation was significantly larger than that in the CR group. The medial contact point between components was located significantly more anterior in the BCR group. In conclusion, BCR-TKA was found to have in vivo kinetics close to those of a normal knee, in comparison with CR-TKA.

Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty

2017 ◽  
Vol 31 (05) ◽  
pp. 453-458 ◽  
Author(s):  
Fidaa Al-Shakfa ◽  
James Moore ◽  
Lydia Mychaltchouk ◽  
Khaled Iguer ◽  
Frédéric Lavoie
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Flexion Contracture ◽  
Early Postoperative Period ◽  
Active Population ◽  
Total Knee ◽  
Comparative Cohort Study ◽  
Bcr Tka

AbstractBicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs. We conducted a retrospective comparative cohort study of 100 BCR TKAs (90 patients) and 100 PS TKAs (88 patients). Knees with a BCR TKA lost significantly more flexion PS TKA in the early postoperative period when their preoperative flexion was less than 130 degrees (loss of 40 degrees vs. loss of 24 degrees). Postoperative range of motion was similar between BCR TKA and PS TKA when preoperative knee flexion was 130 degrees or more, and when there was no preoperative flexion contracture. Postoperative stiffening seems to be more frequent and of greater magnitude after BCR TKA, compared with PS TKA, in patients suffering from preoperative flexion stiffness. Further investigation on the causes of this phenomenon is warranted.

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