Medial congruent polyethylene design show different tibiofemoral kinematics and enhanced congruency compared to a standard symmetrical cruciate retaining design for total knee arthroplasty-an in vivo randomized controlled study of gait using dynamic radiostereometry.
Double-blinded randomized controlled
Gait
Joint congruency
Joint kinematics
Medial congruent
Radiostereometric analysis
Total knee arthroplasty
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
04
01
2022
accepted:
01
06
2022
pubmed:
10
7
2022
medline:
3
3
2023
entrez:
9
7
2022
Statut:
ppublish
Résumé
New total knee arthroplasty implant designs attempt to normalize kinematics patterns that may improve functional performance and patient satisfaction. It was hypothesized that a more medial congruent (MC) anatomic bearing design (1) influences the tibiofemoral kinematics and (2) enhances articular congruency compared to a standard symmetrical cruciate retaining (CR) bearing design. In this double-blinded randomized study, 66 patients with knee osteoarthritis were randomly included in two groups: MC (n = 31) and CR (n = 33). Clinical characteristics such as knee ligament lesions and knee osteoarthritis scores were graded on preoperative magnetic resonance imaging and radiography. At the 1-year follow-up, dynamic radiostereometric analysis was used to assess tibiofemoral joint kinematics and articulation congruency. Patient-reported outcome measures, Oxford Knee Score, the Forgotten Joint Score, and the Knee Osteoarthritis Outcome Score, were assessed preoperatively and at the 1-year follow-up. Compared to the CR bearing, the MC bearing displayed an offset with approximately 3 mm greater anterior tibial drawer (p < 0.001) during the entire motion, and up to approximately 3.5 degrees more tibial external rotation (p = 0.004) from mid-swing to the end of the gait cycle at the 1-year follow-up. Furthermore, the congruency area in the joint articulation was larger during approximately 80% of the gait cycle for the MC bearing compared to the CR. The patient-reported outcome measures improved (p < 0.001), but there were no differences between groups. In addition, there were no differences in clinical characteristics and there were no knee revisions or recognized deep infections during follow-up. The study demonstrates that the MC-bearing design changes tibiofemoral kinematics and increases the area of congruency towards more native knee kinematics than the CR bearing. In perspective this may contribute to a more stabilized knee motion, restoring the patient's confidence in knee function during daily activities.
Identifiants
pubmed: 35809105
doi: 10.1007/s00167-022-07036-w
pii: 10.1007/s00167-022-07036-w
doi:
Substances chimiques
Polyethylene
9002-88-4
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
933-945Informations de copyright
© 2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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