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International Orthopaedics

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01-12-2018 | Original Paper

Knee motion symmetry was not restored in patients with unilateral bi-cruciate retaining total knee arthroplasty—in vivo three-dimensional kinematic analysis

Authors: Paul Arauz, Yun Peng, Young-Min Kwon

Published in: International Orthopaedics | Issue 12/2018

Abstract

Purpose

Although unilateral total knee arthroplasty (TKA) is successful in restoring function, there are concerns in relation to asymmetric gait patterns. Bi-cruciate retaining (BCR) TKA design preserves both anterior and posterior cruciate ligaments with the potential to restore normal joint kinematics. The purpose of this study was to investigate the in vivo three-dimensional (3D) kinematics of the knee in unilateral BCR TKA patients during gait.

Methods

Twenty-nine unilateral BCR TKA patients were evaluated for both knees during treadmill gait using a combined computer tomography and dual fluoroscopic imaging system approach.

Results

Significantly higher flexion (4 ± 6.7°) and internal rotation (4.3 ± 4.7°) and significantly lower adduction (2.5 ± 4.4°) during the stance phase of gait cycle were observed in the implanted side of unilateral BCR TKA patients. Significant asymmetric lateral/medial (3.2 ± 4.8 mm) and anterior/posterior (3.4 ± 4.1 mm) tibial translations were also measured during treadmill gait in this cohort of patients.

Conclusion

Despite maintaining anteroposterior stability, asymmetric knee motion persisted in in vivo unilateral BCR TKA patients during gait. The results of the current study suggested that the knee motion symmetry during gait was not restored in patients with unilateral BCR TKA.

Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133(8):635–646CrossRefPubMed

Hamel MB, Toth M, Legedza A, Rosen MP (2008) Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: decision making, postoperative recovery, and clinical outcomes. Arch Intern Med 168(13):1430–1440. https://doi.org/10.1001/archinte.168.13.1430 CrossRefPubMed

Pua YH, Ong PH, Chong HC, Yeo W, Tan C, Lo NN (2013) Knee extension range of motion and self-report physical function in total knee arthroplasty: mediating effects of knee extensor strength. BMC Musculoskelet Disord 14:33. https://doi.org/10.1186/1471-2474-14-33 CrossRefPubMedPubMedCentral

Alnahdi AH, Zeni JA, Snyder-Mackler L (2011) Gait after unilateral total knee arthroplasty: frontal plane analysis. Journal of orthopaedic research : official publication of the Orthopaedic Research Society 29(5):647–652. https://doi.org/10.1002/jor.21323 CrossRef

Zeni JA Jr, Snyder-Mackler L (2010) Early postoperative measures predict 1- and 2-year outcomes after unilateral total knee arthroplasty: importance of contralateral limb strength. Phys Ther 90(1):43–54. https://doi.org/10.2522/ptj.20090089 CrossRefPubMedPubMedCentral

McGinnis K, Snyder-Mackler L, Flowers P, Zeni J (2013) Dynamic joint stiffness and co-contraction in subjects after total knee arthroplasty. Clinical Biomech (Bristol, Avon) 28(2):205–210. https://doi.org/10.1016/j.clinbiomech.2012.11.008 CrossRef

Mandeville D, Osternig LR, Chou LS (2007) The effect of total knee replacement on dynamic support of the body during walking and stair ascent. Clinical Biomech (Bristol, Avon) 22(7):787–794. https://doi.org/10.1016/j.clinbiomech.2007.04.002 CrossRef

Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L (2008) Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clinical Biomech (Bristol, Avon) 23(3):320–328. https://doi.org/10.1016/j.clinbiomech.2007.10.008 CrossRef

Pozzi F, Snyder-Mackler L, Zeni J Jr (2015) Relationship between biomechanical asymmetries during a step up and over task and stair climbing after total knee arthroplasty. Clinical Biomech (Bristol, Avon) 30(1):78–85. https://doi.org/10.1016/j.clinbiomech.2014.11.001 CrossRef

10.

Shakoor N, Block JA, Shott S, Case JP (2002) Nonrandom evolution of end-stage osteoarthritis of the lower limbs. Arthritis Rheum 46(12):3185–3189. https://doi.org/10.1002/art.10649 CrossRefPubMed

11.

Hobson DA, Torfason LE (1974) Optimization of four-bar knee mechanisms—a computerized approach. J Biomech 7(4):371–376CrossRefPubMed

12.

Freeman MA, Insall JN, Besser W, Walker PS, Hallel T (1977) Excision of the cruciate ligaments in total knee replacement. Clin Orthop Relat Res 1977(126):209–212

13.

Andriacchi TP, Galante JO, Fermier RW (1982) The influence of total knee-replacement design on walking and stair-climbing. J Bone Joint Surg Am 64(9):1328–1335CrossRefPubMed

14.

Fu YC, Simpson KJ, Kinsey TL, Mahoney OM (2013) Does interlimb knee symmetry exist after unicompartmental knee arthroplasty? Clin Orthop Relat Res 471(1):142–149. https://doi.org/10.1007/s11999-012-2522-1 CrossRefPubMed

15.

Milner CE (2008) Interlimb asymmetry during walking following unilateral total knee arthroplasty. Gait Posture 28(1):69–73. https://doi.org/10.1016/j.gaitpost.2007.10.002 CrossRefPubMed

16.

Cappozzo A, Catani F, Croce UD, Leardini A (1995) Position and orientation in space of bones during movement: anatomical frame definition and determination. Clin Biomech (Bristol, Avon) 10(4):171–178CrossRef

17.

Peters A, Galna B, Sangeux M, Morris M, Baker R (2010) Quantification of soft tissue artifact in lower limb human motion analysis: a systematic review. Gait Posture 31(1):1–8. https://doi.org/10.1016/j.gaitpost.2009.09.004 CrossRefPubMed

18.

Tsai TY, Li JS, Wang S, Lin H, Malchau H, Li G, Rubash H, Kwon YM (2013) A novel dual fluoroscopic imaging method for determination of THA kinematics: in-vitro and in-vivo study. J Biomech 46(7):1300–1304. https://doi.org/10.1016/j.jbiomech.2013.02.010 CrossRefPubMed

19.

Qi W, Hosseini A, Tsai TY, Li JS, Rubash HE, Li G (2013) In vivo kinematics of the knee during weight bearing high flexion. J Biomech 46(9):1576–1582. https://doi.org/10.1016/j.jbiomech.2013.03.014 CrossRefPubMedPubMedCentral

20.

Kozanek M, Hosseini A, Liu F, Van de Velde SK, Gill TJ, Rubash HE, Li G (2009) Tibiofemoral kinematics and condylar motion during the stance phase of gait. J Biomech 42(12):1877–1884. https://doi.org/10.1016/j.jbiomech.2009.05.003 CrossRefPubMedPubMedCentral

21.

Tsai TY, Dimitriou D, Li G, Kwon YM (2014) Does total hip arthroplasty restore native hip anatomy? Three-dimensional reconstruction analysis. Int Orthop 38(8):1577–1583. https://doi.org/10.1007/s00264-014-2401-3 CrossRefPubMedPubMedCentral

22.

Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105(2):136–144CrossRefPubMed

23.

Lin H, Wang S, Tsai T-Y, Li G, Kwon Y-M (2013) In-vitro validation of a non-invasive dual fluoroscopic imaging technique for measurement of the hip kinematics. Med Eng Phys 35(3):411–416CrossRefPubMed

24.

Tsai TY, Lu TW, Kuo MY, Lin CC (2011) Effects of soft tissue artifacts on the calculated kinematics and kinetics of the knee during stair-ascent. J Biomech 44(6):1182–1188. https://doi.org/10.1016/j.jbiomech.2011.01.009 CrossRefPubMed

25.

Komnik I, Peters M, Funken J, David S, Weiss S, Potthast W (2016) Non-sagittal knee joint kinematics and kinetics during gait on level and sloped grounds with unicompartmental and total knee arthroplasty patients. PLoS One 11(12):e0168566. https://doi.org/10.1371/journal.pone.0168566 CrossRefPubMedPubMedCentral

26.

Kaufman KR, Miller LS, Sutherland DH (1996) Gait asymmetry in patients with limb-length inequality. J Pediatr Orthop 16(2):144–150CrossRefPubMed

27.

Riley PO, Paolini G, Della Croce U, Paylo KW, Kerrigan DC (2007) A kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. Gait Posture 26(1):17–24. https://doi.org/10.1016/j.gaitpost.2006.07.003 CrossRefPubMed

Title: Knee motion symmetry was not restored in patients with unilateral bi-cruciate retaining total knee arthroplasty—in vivo three-dimensional kinematic analysis
Authors: Paul Arauz
Yun Peng
Young-Min Kwon
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 12/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3986-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Knee motion symmetry was not restored in patients with unilateral bi-cruciate retaining total knee arthroplasty—in vivo three-dimensional kinematic analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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