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In vivo kinematics after a cruciate-substituting TKA

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Abstract
Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Three-dimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was -14.0 mm and -23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8 degrees. The average weightbearing range of motion (ROM) was 109 degrees (range, 60 degrees-150 degrees; standard deviation, 18.7 degrees). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design. Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Keywords
TOTAL KNEE ARTHROPLASTY, CONDYLAR LIFT-OFF, FLUOROSCOPIC ANALYSIS, MULTICENTER ANALYSIS, WEIGHT-BEARING, LIVING KNEE, REPLACEMENTS, WEAR, MOVEMENT, IMPLANT

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Chicago
Victor, Jan, John Kyle P Mueller, Richard D Komistek, Adrija Sharma, Matthew C Nadaud, and Johan Bellemans. 2010. “In Vivo Kinematics After a Cruciate-substituting TKA.” Clinical Orthopaedics and Related Research 468 (3): 807–814.
APA
Victor, J., Mueller, J. K. P., Komistek, R. D., Sharma, A., Nadaud, M. C., & Bellemans, J. (2010). In vivo kinematics after a cruciate-substituting TKA. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 468(3), 807–814.
Vancouver
1.
Victor J, Mueller JKP, Komistek RD, Sharma A, Nadaud MC, Bellemans J. In vivo kinematics after a cruciate-substituting TKA. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 2010;468(3):807–14.
MLA
Victor, Jan, John Kyle P Mueller, Richard D Komistek, et al. “In Vivo Kinematics After a Cruciate-substituting TKA.” CLINICAL ORTHOPAEDICS AND RELATED RESEARCH 468.3 (2010): 807–814. Print.
@article{1967397,
  abstract     = {Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Three-dimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was -14.0 mm and -23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8 degrees. The average weightbearing range of motion (ROM) was 109 degrees (range, 60 degrees-150 degrees; standard deviation, 18.7 degrees). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design. 
Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.},
  author       = {Victor, Jan and Mueller, John Kyle P and Komistek, Richard D and Sharma, Adrija and Nadaud, Matthew C and Bellemans, Johan},
  issn         = {0009-921X},
  journal      = {CLINICAL ORTHOPAEDICS AND RELATED RESEARCH},
  keyword      = {TOTAL KNEE ARTHROPLASTY,CONDYLAR LIFT-OFF,FLUOROSCOPIC ANALYSIS,MULTICENTER ANALYSIS,WEIGHT-BEARING,LIVING KNEE,REPLACEMENTS,WEAR,MOVEMENT,IMPLANT},
  language     = {eng},
  number       = {3},
  pages        = {807--814},
  title        = {In vivo kinematics after a cruciate-substituting TKA},
  url          = {http://dx.doi.org/10.1007/s11999-009-1072-7},
  volume       = {468},
  year         = {2010},
}

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