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Archives of Orthopaedic and Trauma Surgery

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01-05-2017 | Knee Arthroplasty

Kinematic analysis of stair climbing in rotating platform cruciate-retaining and posterior-stabilized mobile-bearing total knee arthroplasties

Authors: Koji Murakami, Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Hiroyuki Nakahara, Hidehiko Higaki, Takeshi Shimoto, Hideki Mizu-uchi, Umito Kuwashima, Yukihide Iwamoto

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2017

Abstract

Introduction

The aim of our study was to compare and contrast the effects of two types of mobile-bearing total knee arthroplasties (TKA), namely, the cruciate-retaining (CR) and posterior-stabilized (PS) TKAs, on clinical outcomes and in vivo kinematics during stair climbing.

Materials and methods

The Press-Fit Condylar Sigma rotating platform was used for both CR and PS TKAs. Patient-reported outcomes were assessed using the 2011 Knee Society Score. Quadriceps muscle strength was evaluated by isokinetic dynamometry. In vivo kinematics were evaluated using periodic sagittal plane radiographic images obtained during stair climbing to quantify anteroposterior (AP) tibiofemoral translation, implant flexion and axial rotation angles using image-matching techniques. Outcomes were evaluated in 20 TKAs, which had been undergone with clinical success, including ten knees with CR types and ten knees with PS types.

Results

There were no significant differences between the CR and PS TKA groups (p > 0.05) in isometric extensor torque (1.0 ± 0.2 and 1.1 ± 0.6 N m/kg, respectively) or patient-reported score for stair climbing function (4.0 ± 0.5 and 3.8 ± 0.9, respectively). Both types of TKAs showed stable AP translation in the mid range of knee flexion and paradoxical translation in the low range of flexion, with limited rotation, during stair climbing. There were no significant differences between the CR and PS TKA groups (P > 0.05) in anterior translation from 80° to 40° of knee flexion (4.2 ± 1.2 and 3.5 ± 1.6 mm, respectively), posterior translation from 40° to 10° of knee flexion (2.3 ± 1.9 and 2.0 ± 1.5 mm, respectively), and total external rotation (2.8° ± 4.9° and 0.5° ± 5.0°, respectively).

Conclusions

Both CR and PS types of rotating platform mobile-bearing TKAs provided reproducible knee joint kinematics during stair climbing and equivalent clinical outcomes.

Level of evidence

IV.

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Title: Kinematic analysis of stair climbing in rotating platform cruciate-retaining and posterior-stabilized mobile-bearing total knee arthroplasties
Authors: Koji Murakami
Satoshi Hamai
Ken Okazaki
Satoru Ikebe
Hiroyuki Nakahara
Hidehiko Higaki
Takeshi Shimoto
Hideki Mizu-uchi
Umito Kuwashima
Yukihide Iwamoto
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2662-6

At a glance: The STEP trials

Springer Medicine

Kinematic analysis of stair climbing in rotating platform cruciate-retaining and posterior-stabilized mobile-bearing total knee arthroplasties

Abstract

Introduction

Materials and methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

Level of evidence

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