Changes in knee kinematics following total knee arthroplasty
Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postope...
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| Veröffentlicht in: | Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine Journal of engineering in medicine, 2016-04, Vol.230 (4), p.265-278 |
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| creator | Akbari Shandiz, Mohsen Boulos, Paul Saevarsson, Stefan Karl Yoo, Sam Miller, Stephen Anglin, Carolyn |
| description | Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin. The purpose of this study was to determine the kinematic degrees of freedom having significant changes and to evaluate the variability in individual changes to allow future study of patients with poor clinical outcomes. We prospectively studied the 6 degrees of freedom patellofemoral and tibiofemoral weightbearing kinematics, tibiofemoral contact points and helical axes of rotation of nine subjects before and at least 1 year after total knee arthroplasty using clinically available computed tomography and radiographic imaging systems. Normal kinematics for healthy individuals were identified from the literature. Significant differences existed between pre–TKA and post–TKA kinematics, with the post-TKA kinematics being closer to normal. While on average the pre–total knee arthroplasty knees in this group displayed no pivoting (only translation), individually only five knees displayed this behaviour (of these, two showed lateral pivoting, one showed medial pivoting and one showed central pivoting). There was considerable variability postoperatively as well (five central, two lateral and two medial pivoting). Both preop and postop, flexion behaviour was more hinge-like medially and more rolling laterally. Helical axes were more consistent postop for this group. An inclusive understanding of the pre–TKA and post–TKA kinematics and changes in kinematics due to total knee arthroplasty could improve implant design, patient diagnosis and surgical technique. |
| doi_str_mv | 10.1177/0954411916632491 |
| format | Article |
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Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin. The purpose of this study was to determine the kinematic degrees of freedom having significant changes and to evaluate the variability in individual changes to allow future study of patients with poor clinical outcomes. We prospectively studied the 6 degrees of freedom patellofemoral and tibiofemoral weightbearing kinematics, tibiofemoral contact points and helical axes of rotation of nine subjects before and at least 1 year after total knee arthroplasty using clinically available computed tomography and radiographic imaging systems. Normal kinematics for healthy individuals were identified from the literature. Significant differences existed between pre–TKA and post–TKA kinematics, with the post-TKA kinematics being closer to normal. While on average the pre–total knee arthroplasty knees in this group displayed no pivoting (only translation), individually only five knees displayed this behaviour (of these, two showed lateral pivoting, one showed medial pivoting and one showed central pivoting). There was considerable variability postoperatively as well (five central, two lateral and two medial pivoting). Both preop and postop, flexion behaviour was more hinge-like medially and more rolling laterally. Helical axes were more consistent postop for this group. An inclusive understanding of the pre–TKA and post–TKA kinematics and changes in kinematics due to total knee arthroplasty could improve implant design, patient diagnosis and surgical technique.</description><identifier>ISSN: 0954-4119</identifier><identifier>EISSN: 2041-3033</identifier><identifier>DOI: 10.1177/0954411916632491</identifier><identifier>PMID: 26936959</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee - adverse effects ; Biomechanical Phenomena - physiology ; Biomedical materials ; Degrees of freedom ; Female ; Helical ; Humans ; Joint surgery ; Kinematics ; Knee Joint - physiopathology ; Knee Joint - surgery ; Knees ; Leg Bones - physiopathology ; Leg Bones - surgery ; Male ; Mathematical analysis ; Medical diagnosis ; Middle Aged ; Patients ; Radiography ; Range of Motion, Articular - physiology ; Surgical implants</subject><ispartof>Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 2016-04, Vol.230 (4), p.265-278</ispartof><rights>IMechE 2016</rights><rights>IMechE 2016.</rights><rights>Copyright SAGE PUBLICATIONS, INC. 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Part H, Journal of engineering in medicine</title><addtitle>Proc Inst Mech Eng H</addtitle><description>Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin. The purpose of this study was to determine the kinematic degrees of freedom having significant changes and to evaluate the variability in individual changes to allow future study of patients with poor clinical outcomes. We prospectively studied the 6 degrees of freedom patellofemoral and tibiofemoral weightbearing kinematics, tibiofemoral contact points and helical axes of rotation of nine subjects before and at least 1 year after total knee arthroplasty using clinically available computed tomography and radiographic imaging systems. Normal kinematics for healthy individuals were identified from the literature. Significant differences existed between pre–TKA and post–TKA kinematics, with the post-TKA kinematics being closer to normal. While on average the pre–total knee arthroplasty knees in this group displayed no pivoting (only translation), individually only five knees displayed this behaviour (of these, two showed lateral pivoting, one showed medial pivoting and one showed central pivoting). There was considerable variability postoperatively as well (five central, two lateral and two medial pivoting). Both preop and postop, flexion behaviour was more hinge-like medially and more rolling laterally. Helical axes were more consistent postop for this group. An inclusive understanding of the pre–TKA and post–TKA kinematics and changes in kinematics due to total knee arthroplasty could improve implant design, patient diagnosis and surgical technique.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Biomechanical Phenomena - physiology</subject><subject>Biomedical materials</subject><subject>Degrees of freedom</subject><subject>Female</subject><subject>Helical</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Kinematics</subject><subject>Knee Joint - physiopathology</subject><subject>Knee Joint - surgery</subject><subject>Knees</subject><subject>Leg Bones - physiopathology</subject><subject>Leg Bones - surgery</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Radiography</subject><subject>Range of Motion, Articular - physiology</subject><subject>Surgical implants</subject><issn>0954-4119</issn><issn>2041-3033</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1Lw0AQxRdRbK3ePUnAi5fofmU3C16k-AWCFz2HzWa2TZtk626C9L83IVWkIJ7m8H7vPWYGoXOCrwmR8garhHNCFBGCUa7IAZpSzEnMMGOHaDrI8aBP0EkIK4wxIVgcowkVigmVqCm6nS91s4AQlU20bgCiddlArdvShMi6qnKfZbOIWtfqatS1b5febSod2u0pOrK6CnC2mzP0_nD_Nn-KX14fn-d3L7FhKm1jkTBONNGMSCMh6XttLnMDNLecGwWyoFoKULjQViiLKTCRU5MCtkkhuWQzdDXmbrz76CC0WV0GA1WlG3BdyEiKMVdpv93_qJQ8YTRVrEcv99CV63zTLzJQSjHOxdCNR8p4F4IHm218WWu_zQjOhidk-0_oLRe74C6vofgxfF-9B-IRCHoBv1r_CvwCdZGM5w</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Akbari Shandiz, Mohsen</creator><creator>Boulos, Paul</creator><creator>Saevarsson, Stefan Karl</creator><creator>Yoo, Sam</creator><creator>Miller, Stephen</creator><creator>Anglin, Carolyn</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QF</scope><scope>7QO</scope><scope>7QQ</scope><scope>7SC</scope><scope>7SE</scope><scope>7SP</scope><scope>7SR</scope><scope>7TA</scope><scope>7TB</scope><scope>7U5</scope><scope>8BQ</scope><scope>8FD</scope><scope>F28</scope><scope>FR3</scope><scope>H8D</scope><scope>H8G</scope><scope>JG9</scope><scope>JQ2</scope><scope>K9.</scope><scope>KR7</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Changes in knee kinematics following total knee arthroplasty</title><author>Akbari Shandiz, Mohsen ; 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Part H, Journal of engineering in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akbari Shandiz, Mohsen</au><au>Boulos, Paul</au><au>Saevarsson, Stefan Karl</au><au>Yoo, Sam</au><au>Miller, Stephen</au><au>Anglin, Carolyn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in knee kinematics following total knee arthroplasty</atitle><jtitle>Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine</jtitle><addtitle>Proc Inst Mech Eng H</addtitle><date>2016-04</date><risdate>2016</risdate><volume>230</volume><issue>4</issue><spage>265</spage><epage>278</epage><pages>265-278</pages><issn>0954-4119</issn><eissn>2041-3033</eissn><abstract>Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin. The purpose of this study was to determine the kinematic degrees of freedom having significant changes and to evaluate the variability in individual changes to allow future study of patients with poor clinical outcomes. We prospectively studied the 6 degrees of freedom patellofemoral and tibiofemoral weightbearing kinematics, tibiofemoral contact points and helical axes of rotation of nine subjects before and at least 1 year after total knee arthroplasty using clinically available computed tomography and radiographic imaging systems. Normal kinematics for healthy individuals were identified from the literature. Significant differences existed between pre–TKA and post–TKA kinematics, with the post-TKA kinematics being closer to normal. While on average the pre–total knee arthroplasty knees in this group displayed no pivoting (only translation), individually only five knees displayed this behaviour (of these, two showed lateral pivoting, one showed medial pivoting and one showed central pivoting). There was considerable variability postoperatively as well (five central, two lateral and two medial pivoting). Both preop and postop, flexion behaviour was more hinge-like medially and more rolling laterally. Helical axes were more consistent postop for this group. An inclusive understanding of the pre–TKA and post–TKA kinematics and changes in kinematics due to total knee arthroplasty could improve implant design, patient diagnosis and surgical technique.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>26936959</pmid><doi>10.1177/0954411916632491</doi><tpages>14</tpages></addata></record> |
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| identifier | ISSN: 0954-4119 |
| ispartof | Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 2016-04, Vol.230 (4), p.265-278 |
| issn | 0954-4119 2041-3033 |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Adult Aged Aged, 80 and over Arthroplasty, Replacement, Knee - adverse effects Biomechanical Phenomena - physiology Biomedical materials Degrees of freedom Female Helical Humans Joint surgery Kinematics Knee Joint - physiopathology Knee Joint - surgery Knees Leg Bones - physiopathology Leg Bones - surgery Male Mathematical analysis Medical diagnosis Middle Aged Patients Radiography Range of Motion, Articular - physiology Surgical implants |
| title | Changes in knee kinematics following total knee arthroplasty |
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