In Vivo Comparison of Knee Kinematics for Subjects Having Either a Posterior Stabilized or Cruciate Retaining High-Flexion Total Knee Arthroplasty

Cates, Hal E.; Komistek, Richard D.; Mahfouz, Mohamed R.; Schmidt, Monica A.; Anderle, Matthew

doi:10.1016/j.arth.2007.09.019

« Previous Next »The Journal of Arthroplasty
Volume 23, Issue 7 , Pages 1057-1067, October 2008

In Vivo Comparison of Knee Kinematics for Subjects Having Either a Posterior Stabilized or Cruciate Retaining High-Flexion Total Knee Arthroplasty

Hal E. Cates, MD
- College of Engineering, Center for Musculoskeletal Research, University of Tennessee, Knoxville, Tennessee
- Tennessee Orthopaedic Clinics, P.C. Knoxville, Tennessee
- Director, Joint Replacement Center, Parkwest Medical Center, Knoxville, Tennessee
Richard D. Komistek, PhD
- College of Engineering, Center for Musculoskeletal Research, University of Tennessee, Knoxville, Tennessee
- Reprint requests: Richard D. Komistek, PhD, University of Tennessee, 301 Perkins Hall, Knoxville, TN 37996-2030.
Mohamed R. Mahfouz, PhD
- College of Engineering, Center for Musculoskeletal Research, University of Tennessee, Knoxville, Tennessee
Monica A. Schmidt, PhD
- Tennessee Orthopaedic Clinics, P.C. Knoxville, Tennessee
Matthew Anderle, BS
- College of Engineering, Center for Musculoskeletal Research, University of Tennessee, Knoxville, Tennessee

Received 18 August 2006; accepted 19 September 2007. published online 14 March 2008.

Abstract

The objective of this study was to determine the in vivo kinematics for subjects having either a fixed posterior stabilized (PS) or cruciate retaining (CR) high-flexion total knee arthroplasty (TKA). Three-dimensional kinematics from full extension to maximum flexion were determined for 30 subjects (15 PS, 15 CR) using fluoroscopy. On average, the PS subjects demonstrated 112° of weight-bearing (WB) flexion, −6.4 mm of posterior femoral rollback, and 2.9° of axial rotation. The CR subjects averaged 117° of WB flexion, −4.9 mm of posterior femoral rollback, and 4.8° of axial rotation. Posterior femoral rollback of the lateral condyle occurred for all PS TKAs and in 93% of the CR TKAs. Only 2 subjects in each group experienced greater than 1.0 mm of condylar lift-off. Subjects in both TKA groups demonstrated excellent WB ranges of motion and kinematic patterns similar to the normal knee, but less in magnitude.

Key words: in vivo, fluoroscopy, total knee arthroplasty, kinematics, high flexion