Total Knee Arthroplasty with a Lateral Centre of Rotation Design Retained Native Knee Joint Kinematics: A Cadaveric Study under Simulated Muscle Loads

The purpose of this work is to describe a computational framework for predicting total knee arthroplasty loads which are necessary for accurate preclinical testing of implant designs. Inputs required include patient knee joint kinematics, and implant type, size, and physiological alignment. Computational models used in the framework include the calculation of knee joint kinematics and kinetics, prediction of the contact path, a model to determine muscle forces, and a force model to obtain parametric solutions for implant forces. The resulting knee implant forces have been validated in two studies, and in both the model accurately predicted differences in knee joint loading. To date, implant contact forces have been predicted for 35 patients with four different implant types. Forces have been calculated for walking, chair, and stair activities.

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Retention of Posterior Cruciate Ligament Alone May Not Achieve Physiological Knee Joint Kinematics After Total Knee Arthroplasty

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.20.00024 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Philippe Moewis ◽

Georg N. Duda ◽

Adam Trepczynski ◽

Leonie Krahl ◽

Christoph K. Boese ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Posterior Cruciate Ligament ◽

Knee Arthroplasty ◽

Cruciate Ligament ◽

Joint Kinematics ◽

Knee Joint Kinematics ◽

Total Knee

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Effects of the medial and lateral tibial slope on knee joint kinematics in total knee arthroplasty

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2018-0051 ◽

2018 ◽

Vol 4 (1) ◽

pp. 207-211

Author(s):

Malte Asseln ◽

Luisa Berger ◽

Mark Verjans ◽

Klaus Radermacher

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Joint Kinematics ◽

Implant Design ◽

Initial Slope ◽

Knee Joint Kinematics ◽

Total Knee ◽

Patellofemoral Kinematics

AbstractImplant design in total knee arthroplasty is a key factor for the recovery of function and mobility of the joint. However, there is a lack of knowledge on the complex relationship between design features and the biomechanical situation. The posterior inclination of the tibial plateau (tibial slope) has a known functional impact on knee joint kinematics. In the native knee it shows high inter-individual differences, which is inadequately considered in total knee arthroplasty. We investigated the effects of the separate and combined variation of the medial and lateral tibial slope on knee joint kinematics in an in vitro setup. Therefore, the medial and lateral inserts of a knee implant were parameterised and the initial slope was gradually varied to +4°, +2° (posterior) and -2°, -4° (anterior). The variations were manufactured by using polymer based rapid prototyping. The effects on semi-active tibiofemoral and patellofemoral kinematics were studied and quantified in terms of the Root Mean Square Error and Pearson’s Correlation coefficient. The overall largest effect was observed on tibiofemoral internal-external rotation by the variation of the lateral insert. The anterior-posterior translation was predominantly effected by the combined variation. Nevertheless, the lateral variation showed greater influence than medial. In contrast, changes in patellofemoral kinematics were small. Our findings suggest that in total knee arthroplasty the lateral tibial slope has a larger functional effect than the medial tibial slope. Thus, functional design optimization should focus on the lateral insert.

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