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- Title
Mobility of the rotating platform in low contact stress knee arthroplasty is durable.
- Authors
Zürcher, Arthur; Hutten, Kim; Harlaar, Jaap; Pöll, Ruud; Zürcher, Arthur; van Hutten, Kim; Pöll, Ruud
- Abstract
<bold>Purpose: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.<bold>Level Of Evidence: </bold>Therapeutic study, Level III.
- Subjects
TOTAL knee replacement; SURGEONS; PATELLOFEMORAL joint; OSTEOARTHRITIS; RHEUMATOID arthritis; PATIENTS; KNEE physiology; ARTIFICIAL joints; GAIT in humans; RANGE of motion of joints; KINEMATICS; LONGITUDINAL method; COMPLICATIONS of prosthesis; ROTATIONAL motion; BODY movement; CROSS-sectional method
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 8, p2580
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-015-3823-1