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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2017

01-08-2017 | Knee

Mobility of the rotating platform in low contact stress knee arthroplasty is durable

Authors: Arthur Zürcher, Kim van Hutten, Jaap Harlaar, Ruud Pöll

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2017

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Abstract

Purpose

The mobile bearing or rotating platform (RP) in total knee arthroplasty (TKA) is originally part of a low contact stress (LCS) concept, with bearing undersurface mobility compensating higher bearing upper-surface congruency. The in vivo range of axial femorotibial rotation in RP knees has been the subject of many studies, but always involving the performance of relatively low demanding task conditions. Hardly any study has addressed the maintenance of this rotation over time.

Methods

Two consecutive series of patients with LCS RP knees were studied in a cross-sectional study of 1- and 5-year follow-up. They were assessed using optoelectronic movement analysis during gait and the performance of a sit-to-walk (STW) task with and without turning steps.

Results

A mean range of rotation (SD) was found in the 1-year group of 13.4° (3.7) during gait, 17.8° (6.8) during STW straight, and 17.9° (6.9) during STW with turning. The range in the 5-year group was 11.2° (6.0) during gait, 18.5° (8.7) during STW straight, and 18.3° (8.3) during STW with turning. A so-called paradoxical axial rotation pattern during gait and STW straight occurred in both groups in a normal prevalence.

Conclusion

The amount and pattern of rotation in a LCS RP knee does not become impaired between 1 and 5 years postoperatively. The theoretical benefit of RP TKA has not been proven in any clinical study so far, and studies with suitable long-term follow-up need to prove whether this mobility also leads to improved prosthesis survival. However, our findings support the functioning of the rotating platform at a basal science level and illustrate the need for the use of more complex tasks in kinematic studies.

Level of evidence

Therapeutic study, Level III.
Appendix
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Metadata
Title
Mobility of the rotating platform in low contact stress knee arthroplasty is durable
Authors
Arthur Zürcher
Kim van Hutten
Jaap Harlaar
Ruud Pöll
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3823-1

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