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Archives of Orthopaedic and Trauma Surgery

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01-06-2022 | Knee Arthroplasty

Impact of femoro-tibial size combinations and TKA design on kinematics

Authors: Ingrid Dupraz, Christoph Thorwächter, Thomas M. Grupp, Florian Hammerschmid, Matthias Woiczinski, Volkmar Jansson, Peter E. Müller, Arnd Steinbrück

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2022

Abstract

Introduction

The variability in patients’ femoral and tibial anatomy requires to use different tibia component sizes with the same femoral component size. These size combinations are allowed by manufacturers, but the clinical impact remains unclear. Therefore, the goals of our study were to investigate whether combining different sizes has an impact on the kinematics for two well-established knee systems and to compare these systems’ kinematics to the native kinematics.

Materials and methods

Six fresh frozen knee specimens were tested in a force controlled knee rig before and after implantation of a cruciate retaining (CR) and a posterior-stabilized (PS) implant. Femoro-tibial kinematics were recorded using a ultrasonic-based motion analysis system while performing a loaded squat from 30° to 130°. In each knee, the original best fit inlay was then replaced by different inlays simulating a smaller or bigger tibia component. The kinematics obtained with the simulated sizes were compared to the original inlay kinematics using descriptive statistics.

Results

For all size combinations, the difference to the original kinematics reached an average of 1.3 ± 3.3 mm in translation and − 0.1 ± 1.2° in rotation with the CR implant. With the PS implant, the average differences reached 0.4 ± 2.7 mm and − 0.2 ± 0.8°. Among all knees, no size combination consistently resulted in significantly different kinematics.

Each knee showed a singular kinematic pattern. For both knee systems, the rotation was smaller than in the native knee, but the direction of the rotation was preserved. The PS showed more rollback and the CR less rollback than the native knee.

Conclusion

TKA systems designed with a constant tibio-femoral congruency among size combinations should enable to combine different sizes without having substantial impact on the kinematics. The rotational pattern was preserved by both TKA systems, while the rollback could only be maintained by the PS design.

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Title: Impact of femoro-tibial size combinations and TKA design on kinematics
Authors: Ingrid Dupraz
Christoph Thorwächter
Thomas M. Grupp
Florian Hammerschmid
Matthias Woiczinski
Volkmar Jansson
Peter E. Müller
Arnd Steinbrück
Publication date: 01-06-2022
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03923-y

At a glance: The STEP trials

Springer Medicine

Impact of femoro-tibial size combinations and TKA design on kinematics

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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