Biomechanical Assessment of Mobile-Bearing Total Knee Endoprostheses Using Musculoskeletal Simulation

The purpose of this computational study was to analyze the effects of different mobile-bearing (MB) total knee replacement (TKR) designs on knee joint biomechanics. A validated musculoskeletal model of the lower right extremity implanted with a cruciate-retaining fixed-bearing TKR undergoing a squat motion was adapted for three different MB TKR design variants: (I) a commercially available TKR design allowing for tibial insert rotation about the tibial tray with end stops to limit the range of rotation, (II) the same design without end stops, and (III) a multidirectional design with an additional translational degree-of-freedom (DoF) and end stops. When modeling the MB interface, two modeling strategies of different joint topologies were deployed: (1) a six DoF joint as a baseline and (2) a combined revolute-prismatic joint (two DoF joint) with end stops in both DoF. Altered knee joint kinematics for the three MB design variants were observed. The commercially available TKR design variant I yielded a deviation in internal-external rotation of the tibial insert relative to the tray up to 5° during knee flexion. Compared to the multidirectional design variant III, the other two variants revealed less femoral anterior-posterior translation by as much as 5 mm. Concerning the modeling strategies, the two DoF joint showed less computation time by 68%, 80%, and 82% for design variants I, II, and III, respectively. However, only slight differences in the knee joint kinematics of the two modeling strategies were recorded. In conclusion, knee joint biomechanics during a squat motion differed for each of the simulated MB design variants. Specific implant design elements, such as the presence of end stops, can impact the postoperative range of knee motion with regard to modeling strategy, and the two DoF joint option tested accurately replicated the results for the simulated designs with a considerably lower computation time than the six DoF joint. The proposed musculoskeletal multibody simulation framework is capable of virtually characterizing the knee joint dynamics for different TKR designs.

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Knee joint kinematics, fixation and function related to joint area design in total knee arthroplasty

Acta Orthopaedica Scandinavica ◽

10.1080/000164702760300299 ◽

2001 ◽

Vol 72 (sup299) ◽

pp. 1-52 ◽

Cited By ~ 1

Author(s):

Johan Uvehammer

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Arthroplasty ◽

Joint Kinematics ◽

Joint Area ◽

Knee Joint Kinematics ◽

Total Knee ◽

And Function

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Computational Framework for Determining Patient-Specific Total Knee Arthroplasty Loading

Journal of Medical Devices ◽

10.1115/1.4025765 ◽

2013 ◽

Vol 7 (4) ◽

Author(s):

Hannah J. Lundberg ◽

Markus A. Wimmer

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Arthroplasty ◽

Joint Kinematics ◽

Contact Forces ◽

Patient Specific ◽

Force Model ◽

Computational Framework ◽

Knee Joint Kinematics ◽

Total Knee

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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