INTRODUCTION: This study determined the relationship between the in vivo kinematics and joint laxity of mobile-bearing knees. MATERIALS AND METHODS: Ten subjects who were judged clinically successful after a posterior-cruciate-ligament-retaining mobile-bearing total knee arthroplasty were analyzed under dynamic conditions using fluoroscopy, following a quantitative evaluation of coronal and sagittal laxity using Telos and KT-2000 arthrometers under static conditions. RESULTS: Under static conditions, the anteroposterior laxity averaged 10.3 mm at 30 degrees of flexion, and 8.3 mm at 75 degrees . Abduction and adduction at full extension averaged 3.7 and 4.4 mm, respectively. Under dynamic conditions, 7/10 subjects demonstrated posterior femoral rollback of their lateral condyle moving from full extension to maximum knee flexion, and 8/10 experienced normal axial rotation patterns during deep knee bend activity. Furthermore, 7/10 subjects exhibited screw-home motion. 4/10 subjects experienced greater than 1.0 mm of condylar liftoff. CONCLUSION: We could not predict a consistent relationship between the laxity and kinematics. The activity of the muscles and ligamentous tension under dynamic conditions might have a much greater effect on the kinematics with currently used prosthetic designs than the laxity of ligamentous structures under static conditions.
INTRODUCTION: This study determined the relationship between the in vivo kinematics and joint laxity of mobile-bearing knees. MATERIALS AND METHODS: Ten subjects who were judged clinically successful after a posterior-cruciate-ligament-retaining mobile-bearing total knee arthroplasty were analyzed under dynamic conditions using fluoroscopy, following a quantitative evaluation of coronal and sagittal laxity using Telos and KT-2000 arthrometers under static conditions. RESULTS: Under static conditions, the anteroposterior laxity averaged 10.3 mm at 30 degrees of flexion, and 8.3 mm at 75 degrees . Abduction and adduction at full extension averaged 3.7 and 4.4 mm, respectively. Under dynamic conditions, 7/10 subjects demonstrated posterior femoral rollback of their lateral condyle moving from full extension to maximum knee flexion, and 8/10 experienced normal axial rotation patterns during deep knee bend activity. Furthermore, 7/10 subjects exhibited screw-home motion. 4/10 subjects experienced greater than 1.0 mm of condylar liftoff. CONCLUSION: We could not predict a consistent relationship between the laxity and kinematics. The activity of the muscles and ligamentous tension under dynamic conditions might have a much greater effect on the kinematics with currently used prosthetic designs than the laxity of ligamentous structures under static conditions.
Authors: A M ten Ham; P J C Heesterbeek; D B van der Schaaf; W C H Jacobs; A B Wymenga Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-04-29 Impact factor: 4.342