Highlights
- •Weight-bearing and non-weight-bearing deep knee bending were evaluated.
- •The medial side of the femur showed no anterior motion in the two states.
- •Anteroposterior position of the lateral side differed in the mid-flexion range.
- •Femoral rotational kinematics were different between the two states.
- •Effect of weight-bearing on kinematics was small in the medial compartment.
Abstract
Background
This study aimed to determine the kinematics of medial pivot total knee arthroplasty
by comparing weight-bearing and non-weight-bearing deep knee bending and to evaluate
the effect of the weight-bearing state on the kinematics.
Methods
The kinematics of 19 knees were investigated under fluoroscopy during squatting (weight-bearing)
and active-assisted knee bending (non-weight-bearing) using two- to three-dimensional
registration technique. Accordingly, range of motion, anteroposterior translation
for the medial and lateral low contact points, axial rotation of the femoral component
relative to the tibial component and kinematic pathway were evaluated.
Findings
There was no difference in range of motion between the two states. The medial anteroposterior
translation showed no significant movement with no anterior translation in both the
weight-bearing and non-weight-bearing from 0° to 90° of flexion. Regarding the lateral
anteroposterior translation, a posterior translation was observed during weight-bearing,
whereas a slight anterior translation from 0° to 30° of flexion and subsequent posterior
translation were found in the non-weight-bearing. Femoral external rotation was observed
in the weight-bearing, whereas femoral internal rotation was seen from 0° to 30° of
flexion and subsequent femoral external rotation was observed in the non-weight-bearing.
The kinematic pathway showed medial pivot motion and subsequent bicondylar rollback
in the weight-bearing, whereas only medial pivot motion was observed in the non-weight-bearing.
Interpretation
The medial anteroposterior translation of the femur during deep knee bending showed
no anterior motion in the two states. The lateral anteroposterior translation and
femoral rotation were different in the mid-flexion range between the two states.
Keywords
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Article info
Publication history
Published online: September 09, 2022
Accepted:
September 6,
2022
Received:
April 15,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
