Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

RETRACTED ARTICLE: Effect of sagittal femoral component alignment on biomechanics after mobile-bearing total knee arthroplasty

Authors: Yong-Gon Koh, Jin-Ah Lee, Hwa-Yong Lee, Dong-Suk Suh, Hyo-Jeong Kim, Kyoung-Tak Kang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Login to get access

Abstract

Background

Recently, there has been increasing interest in mobile-bearing total knee arthroplasty (TKA). However, changes in biomechanics with respect to femoral component alignment in mobile-bearing TKA have not been explored in depth. This study aims to evaluate the biomechanical effect of sagittal alignment of the femoral component in mobile-bearing TKA.

Methods

We developed femoral sagittal alignment models with − 3°, 0°, 3°, 5°, and 7°. We also examined the kinematics of the tibiofemoral (TF) joint, contact point on the TF joint, contact stress on the patellofemoral (PF) joint, collateral ligament force, and quadriceps force using a validated computational model under a deep-knee-bend condition.

Results

Posterior kinematics of the TF joint increased as the femoral component flexed. In addition, contact stress on the PF joint, collateral ligament force, and quadriceps force decreased as the femoral component flexed. The results of this study can assist surgeons in assessing risk factors associated with femoral component sagittal alignment for mobile-bearing TKA.

Conclusions

Our results showed that slight flexion implantation may be an effective alternative technique because of its advantageous biomechanical effect. However, excessive flexion should be avoided because of potential loosening of the TF joint.
Literature
1.
Argenson JN, O'Connor JJ. Polyethylene wear in meniscal knee replacement. A one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg Br. 1992;74(2):228–32.PubMed
2.
Buechel FF, Pappas MJ. The New Jersey low-contact-stress knee replacement system: biomechanical rationale and review of the first 123 cemented cases. Arch Orthop Trauma Surg. 1986;105(4):197–204.PubMed
3.
Buechel FF, Pappas MJ. New Jersey low contact stress knee replacement system. Ten-year evaluation of meniscal bearings. Orthop Clin North Am. 1989;20(2):147–77.PubMed
4.
Watanabe T, Yamazaki T, Sugamoto K, Tomita T, Hashimoto H, Maeda D, et al. In vivo kinematics of mobile-bearing knee arthroplasty in deep knee bending motion. J Orthop Res. 2004;22(5):1044–9.PubMed
5.
Fantozzi S, Leardini A, Banks SA, Marcacci M, Giannini S, Catani F. Dynamic in-vivo tibio-femoral and bearing motions in mobile bearing knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2004;12(2):144–51.PubMed
6.
Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br. 1998;80(6):983–9.CrossRef
7.
Psychoyios V, Crawford RW, O'Connor JJ, Murray DW. Wear of congruent meniscal bearings in unicompartmental knee arthroplasty: a retrieval study of 16 specimens. J Bone Joint Surg Br. 1998;80(6):976–82.PubMed
8.
Jordan LR, Olivo JL, Voorhorst PE. Survivorship analysis of cementless meniscal bearing total knee arthroplasty. Clin Orthop Relat Res. 1997;338:119–23.
9.
Dennis DA, Komistek RD, Stiehl JB, Walker SA, Dennis KN. Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty. 1998;13(7):748–52.PubMed
10.
Harvey IA, Barry K, Kirby SP, Johnson R, Elloy MA. Factors affecting the range of movement of total knee arthroplasty. J Bone Joint Surg Br. 1993;75(6):950–5.PubMed
11.
Berger RA, Crossett LS, Jacobs JJ, Rubash HE. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res. 1998;356:144–53.
12.
Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. 1993;286:40–7.
13.
Eckhoff DG, Metzger RG, Vandewalle MV. Malrotation associated with implant alignment technique in total knee arthroplasty. Clin Orthop Relat Res. 1995;321:28–31.
14.
Kaper BP, Smith PN, Bourne RB, Rorabeck CH, Robertson D. Medium-term results of a mobile bearing total knee replacement. Clin Orthop Relat Res. 1999;367:201–9.
15.
Matsui Y, Kadoya Y, Uehara K, Kobayashi A, Takaoka K. Rotational deformity in varus osteoarthritis of the knee: analysis with computed tomography. Clin Orthop Relat Res. 2005;433:147–51.
16.
Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C. A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg Am. 2007;89(2):236–43.PubMed
17.
Nakahara H, Matsuda S, Okazaki K, Tashiro Y, Iwamoto Y. Sagittal cutting error changes femoral anteroposterior sizing in total knee arthroplasty. Clin Orthop Relat Res. 2012;470(12):3560–5.PubMedPubMedCentral
18.
Tsukeoka T, Lee TH. Sagittal flexion of the femoral component affects flexion gap and sizing in total knee arthroplasty. J Arthroplasty. 2012;27(6):1094–9.PubMed
19.
Kang KT, Kim SH, Son J, Lee YH, Chun HJ. Computational model-based probabilistic analysis of in vivo material properties for ligament stiffness using the laxity test and computed tomography. J Mater Sci Mater Med. 2016;27(12):183.PubMed
20.
Koh YG, Son J, Kwon SK, Kim HJ, Kwon OR, Kang KT. Preservation of kinematics with posterior cruciate-, bicruciate- and patient-specific bicruciate-retaining prostheses in total knee arthroplasty by using computational simulation with normal knee model. Bone & joint research. 2017;6(9):557–65.
21.
Kang KT, Son J, Suh DS, Kwon SK, Kwon OR, Koh YG. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: a finite element analysis. Bone & joint research. 2018;7(1):20–7.
22.
Kim YS, Kang KT, Son J, Kwon OR, Choi YJ, Jo SB, et al. Graft extrusion related to the position of allograft in lateral meniscal allograft transplantation: biomechanical comparison between parapatellar and transpatellar approaches using finite element analysis. Arthroscopy. 2015;31(12):2380–91.PubMed
23.
Peña E, Calvo B, Martinez MA, Palanca D, Doblaré M. Why lateral meniscectomy is more dangerous than medial meniscectomy. A finite element study. J Orthop Res. 2006;24(5):1001–10.PubMed
24.
Blankevoort L, Huiskes R. Validation of a three-dimensional model of the knee. J Biomech. 1996;29(7):955–61.PubMed
25.
Mesfar W, Shirazi-Adl A. Biomechanics of the knee joint in flexion under various quadriceps forces. The Knee. 2005;12(6):424–34.PubMed
26.
Piefer JW, Pflugner TR, Hwang MD, Lubowitz JH. Anterior cruciate ligament femoral footprint anatomy: systematic review of the 21st century literature. Arthroscopy. 2012;28(6):872–81.PubMed
27.
Bowman KF Jr, Sekiya JK. Anatomy and biomechanics of the posterior cruciate ligament, medial and lateral sides of the knee. Sports Med Arthrosc. 2010;18(4):222–9.PubMed
28.
Baldwin JL. The anatomy of the medial patellofemoral ligament. Am J Sports Med. 2009;37(12):2355–61.PubMed
29.
Godest AC, Beaugonin M, Haug E, Taylor M, Gregson PJ. Simulation of a knee joint replacement during a gait cycle using explicit finite element analysis. J Biomech. 2002;35(2):267–75.PubMed
30.
Inoue S, Akagi M, Asada S, Mori S, Zaima H, Hashida M. The valgus inclination of the tibial component increases the risk of medial tibial condylar fractures in unicompartmental knee arthroplasty. J Arthroplasty. 2016;31(9):2025–30.PubMed
31.
Pegg EC, Walter J, Mellon SJ, Pandit HG, Murray DW, D'Lima DD, et al. Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement. J Orthop Res. 2013;31(5):821–8.PubMed
32.
Vanlommel J, Luyckx JP, Labey L, Innocenti B, De Corte R, Bellemans J. Cementing the tibial component in total knee arthroplasty: which technique is the best? J Arthroplasty. 2011;26(3):492–6.PubMed
33.
Kang K-T, Son J, Kwon SK, Kwon O-R, Park J-H, Koh Y-G. Finite element analysis for the biomechanical effect of tibial insert materials in total knee arthroplasty. Composite Structures. 2018;201:141–50.
34.
Ishii Y, Noguchi H, Matsuda Y, Takeda M, Walker SA, Komistek RD. Effect of knee laxity on in vivo kinematics of meniscal-bearing knee prostheses. The Knee. 2007;14(4):269–74.PubMed
35.
Kang KT, Koh YG, Son J, Kwon OR, Baek C, Jung SH, et al. Measuring the effect of femoral malrotation on knee joint biomechanics for total knee arthroplasty using computational simulation. Bone & joint research. 2016;5(11):552–9.
36.
Kutzner I, Heinlein B, Graichen F, Bender A, Rohlmann A, Halder A, et al. Loading of the knee joint during activities of daily living measured in vivo in five subjects. J Biomech. 2010;43(11):2164–73.PubMed
37.
Kang KT, Koh YG, Son J, Kim SJ, Choi S, Jung M, et al. Finite element analysis of the biomechanical effects of three posterolateral corner reconstruction techniques for the knee joint. Arthroscopy. 2017;33(8):1537–50.PubMed
38.
Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983;105(2):136–44.PubMed
39.
Callaghan JJ, Insall JN, Greenwald AS, Dennis DA, Komistek RD, Murray DW, et al. Mobile-bearing knee replacement: concepts and results. Instr Course Lect. 2001;50:431–49.PubMed
40.
Walker PS, Yildirim G, Sussman-Fort J, Roth J, White B, Klein GR. Factors affecting the impingement angle of fixed- and mobile-bearing total knee replacements: a laboratory study. J Arthroplasty. 2007;22(5):745–52.PubMed
41.
Walker PS, Garg A. Range of motion in total knee arthroplasty. A computer analysis. Clin Orthop Relat Res. 1991;262:227–35.
42.
Kang KT, Koh YG, Son J, Kwon OR, Lee JS, Kwon SK. Influence of increased posterior tibial slope in total knee arthroplasty on knee joint biomechanics: a computational simulation study. J Arthroplasty. 2018;33(2):572–9.PubMed
43.
Thompson JA, Hast MW, Granger JF, Piazza SJ, Siston RA. Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res. 2011;29(7):969–75.PubMed
44.
Mizu-uchi H, Colwell CW Jr, Matsuda S, Flores-Hernandez C, Iwamoto Y, D'Lima DD. Effect of total knee arthroplasty implant position on flexion angle before implant-bone impingement. J Arthroplasty. 2011;26(5):721–7.PubMed
45.
Dennis DA, Komistek RD, Hoff WA, Gabriel SM. In vivo knee kinematics derived using an inverse perspective technique. Clin Orthop Relat Res. 1996;331:107–17.
46.
Stiehl JB, Dennis DA, Komistek RD, Keblish PA. In vivo kinematic comparison of posterior cruciate ligament retention or sacrifice with a mobile bearing total knee arthroplasty. Am J Knee Surg. 2000;13(1):13–8.PubMed
47.
Haas BD, Komistek RD, Stiehl JB, Anderson DT, Northcut EJ. Kinematic comparison of posterior cruciate sacrifice versus substitution in a mobile bearing total knee arthroplasty. J Arthroplasty. 2002;17(6):685–92.PubMed
48.
Kobori M, Komistek R, Dennis D. An in vivo determination of patellar kinematics for fixed and mobile bearing TKA having a resurfaced and unresurfaced patellae. Los Angeles: Annual Meeting of the American Academy of the Orthopaedic Surgeons; 2001.
49.
Massin P, Gournay A. Optimization of the posterior condylar offset, tibial slope, and condylar roll-back in total knee arthroplasty. J Arthroplasty. 2006;21(6):889–96.PubMed
50.
Fantozzi S, Catani F, Ensini A, Leardini A, Giannini S. Femoral rollback of cruciate-retaining and posterior-stabilized total knee replacements: in vivo fluoroscopic analysis during activities of daily living. J Orthop Res. 2006;24(12):2222–9.PubMed
51.
D'Lima DD, Poole C, Chadha H, Hermida JC, Mahar A, Colwell CW Jr. Quadriceps moment arm and quadriceps forces after total knee arthroplasty. Clin Orthop Relat Res. 2001;392:213–20.
52.
Fujimoto E, Sasashige Y, Tomita T, Iwamoto K, Masuda Y, Hisatome T. Significant effect of the posterior tibial slope on the weight-bearing, midflexion in vivo kinematics after cruciate-retaining total knee arthroplasty. J Arthroplasty. 2014;29(12):2324–30.PubMed
53.
Ostermeier S, Hurschler C, Windhagen H, Stukenborg-Colsman C. In vitro investigation of the influence of tibial slope on quadriceps extension force after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2006;14(10):934–9.PubMed
54.
Malviya A, Lingard EA, Weir DJ, Deehan DJ. Predicting range of movement after knee replacement: the importance of posterior condylar offset and tibial slope. Knee Surg Sports Traumatol Arthrosc. 2009;17(5):491–8.PubMed
55.
Mizner RL, Petterson SC, Stevens JE, Vandenborne K, Snyder-Mackler L. Early quadriceps strength loss after total knee arthroplasty. The contributions of muscle atrophy and failure of voluntary muscle activation. J Bone Joint Surg Am. 2005;87(5):1047–53.PubMedPubMedCentral
56.
Marra MA, Strzelczak M, Heesterbeek PJC, van de Groes SAW, Janssen DW, Koopman B, et al. Anterior referencing of tibial slope in total knee arthroplasty considerably influences knee kinematics: a musculoskeletal simulation study. Knee Surg Sports Traumatol Arthrosc. 2018;26(5):1540–8.PubMed
57.
Fang DM, Ritter MA, Davis KE. Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty. 2009;24(6 Suppl):39–43.PubMed
58.
Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991;73(5):709–14.PubMed
59.
Antony J, Tetsworth K, Hohmann E. Influence of sagittal plane component alignment on kinematics after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1686–91.PubMed
60.
Chen SC, Zeng YM, Yan MN, Yue B, Zhang J, Wang Y. Effect of femoral component flexion implantation on the mediolateral bone-prosthetic fit in total knee arthroplasty. Orthopaedic surgery. 2017;9(1):91–6.PubMedPubMedCentral
61.
Kim YH, Park JW, Kim JS, Park SD. The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. International orthopaedics. 2014;38(2):379–85.PubMed
62.
Zalzal P, Backstein D, Gross AE, Papini M. Notching of the anterior femoral cortex during total knee arthroplasty characteristics that increase local stresses. J Arthroplasty. 2006;21(5):737–43.PubMed
63.
Kang KT, Koh YG, Son J, Kwon OR, Park KK. Flexed femoral component improves kinematics and biomechanical effect in posterior stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;27(4):1174–81.
Metadata
Title
RETRACTED ARTICLE: Effect of sagittal femoral component alignment on biomechanics after mobile-bearing total knee arthroplasty
Authors
Yong-Gon Koh
Jin-Ah Lee
Hwa-Yong Lee
Dong-Suk Suh
Hyo-Jeong Kim
Kyoung-Tak Kang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1458-5

Other articles of this Issue 1/2019

Journal of Orthopaedic Surgery and Research 1/2019 Go to the issue

Research article

Autologous stem cell-derived chondrocyte implantation with bio-targeted microspheres for the treatment of osteochondral defects

Research article

Comparison of lateral approach versus anterolateral approach with Herbert screw fixation for isolated coronal shear fractures of humeral capitellum

Research article

Failure analysis of primary surgery and therapeutic strategy of revision surgery for complex tibial plateau fractures

Research article

Efficacy of magnetic resonance imaging with an SPGR sequence for the early evaluation of knee cartilage degeneration and the relationship between cartilage and other tissues

Research article

Analysis of the stress distribution of the subtalar joint and fusion efficacy after double-screw insertion

Research article

Oblique lumbar interbody fusion for adjacent segment disease after posterior lumbar fusion: a case-controlled study