Does a mobile-bearing, high-flexion design increase knee flexion after total knee replacement?

Having demonstrated in Chapter 2 that a fully conforming mobile bearing can minimise polyethylene wear, in this chapter we show that a mobile bearing prosthesis, unconstrained in the sagittal plane, can restore natural mobility and stability. For surgeon readers who are less interested in the theoretical background, it might be advisable to go straight to Chapter 4, Indications, or to start by reading the final section of this chapter, The Loaded Prosthetic Knee. If that proves interesting, the surgeon might attempt The Unloaded Prosthetic Knee. For the more research minded surgeon or engineer, it seems more logical to start with the Unloaded Natural Knee (the longest section of the chapter) and to read from there. The chapter may also be of interest to those surgeons embarking on the use of a bi-cruciate retaining total knee replacement.

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Preoperative Low Back Pain Affects Recovery in Knee Flexion Range of Motion Following Total Knee Replacement

Critical Reviews in Physical and Rehabilitation Medicine ◽

10.1615/critrevphysrehabilmed.2016018885 ◽

2016 ◽

Vol 28 (1-2) ◽

pp. 47-55

Author(s):

Hannah M. Ashworth ◽

Christian N. Warner ◽

Saurabh P Mehta ◽

Franklin D. Shuler ◽

Ali Oliashirazi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Total Knee Replacement ◽

Range Of Motion ◽

Knee Replacement ◽

Knee Flexion ◽

Low Back ◽

Total Knee

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Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

BioMed Research International ◽

10.1155/2015/157541 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Markus A. Wimmer ◽

William Nechtow ◽

Thorsten Schwenke ◽

Kirsten C. Moisio

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Knee Flexion ◽

Daily Activities ◽

Wear Testing ◽

Significant Difference ◽

Flexion Extension ◽

Total Knee ◽

Stair Walking ◽

The Many

Walking is only one of many daily activities performed by patients following total knee replacement (TKR). The purpose of this study was to examine the hypotheses (a) that subject activity characteristics are correlated with knee flexion range of motion (ROM) and (b) that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857) walking cycles including 65 (range: 0–319) stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

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Fixed versus mobile bearing total knee replacement: methodological considerations in systematic reviewing

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-010-1103-7 ◽

2010 ◽

Vol 18 (5) ◽

pp. 704-706

Author(s):

Toby O. Smith ◽

Simon T. Donell ◽

Caroline B. Hing

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Mobile Bearing ◽

Total Knee ◽

Methodological Considerations

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The incidence of the patellar clunk syndrome in a recently designed mobile-bearing posteriorly stabilised total knee replacement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.91b4.21494 ◽

2009 ◽

Vol 91-B (4) ◽

pp. 463-468 ◽

Cited By ~ 47

Author(s):

K. Fukunaga ◽

A. Kobayashi ◽

Y. Minoda ◽

H. Iwaki ◽

Y. Hashimoto ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Mobile Bearing ◽

Total Knee

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Gap Deviation after Cementation in Computer Assisted Navigation TKA

10.29007/t7tz ◽

2019 ◽

Author(s):

Chumroonkiet Leelasestaporn ◽

Tomorn Tarnpichprasert

Keyword(s):

Soft Tissue ◽

Total Knee Replacement ◽

Knee Replacement ◽

Mechanical Axis ◽

Mobile Bearing ◽

Flexion Contracture ◽

Implant Design ◽

Computer Assisted ◽

Assisted Navigation ◽

Total Knee

INTRODUCTIONThe outcome of knee replacement depended on alignment, balancing of soft tissue, symmetrical andrectangular gaps adjustment, and accurate implant placement. Many techniques have been used toimprove these factors including navigator assisted knee replacement, which has precise bone cutand accurate soft tissue balancing. However, cementation may change gaps and alignment that canaffect outcome of knee replacement.OBJECTIVETo compare gaps and alignment after cementation in computer assisted total knee replacementMATERIAL AND METHODSProspective collecting data all cases performed computer assisted total knee replacement withcruciate retaining - mobile bearing implant design. Gaps and mechanical axis was collected andcompered between complete trial prosthesis and final cementation.RESULTLateral extension gap and flexion contracture significantly increase after cementation whencompared with trial implantation [0.6 mm (P = 0.021), 2.7o (P = 0.00)]. The mechanical axis was notdeviated after cementation (P = 1.00).CONCLUSIONCementation is able to influence gap and alignment. It may be useful to control and recheck gap andalignment with navigation system during cementation. Clinical correlation needs furtherinvestigation.

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