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- Title
Is the posterior cruciate ligament necessary for medial pivot knee prostheses with regard to postoperative kinematics?
- Authors
Fang, Chao-Hua; Chang, Chia-Ming; Lai, Yu-Shu; Chen, Wen-Chuan; Song, Da-Yong; McClean, Colin; Kao, Hao-Yuan; Qu, Tie-Bing; Cheng, Cheng-Kung; McClean, Colin J
- Abstract
<bold>Purpose: </bold>Excellent clinical and kinematical performance is commonly reported after medial pivot knee arthroplasty. However, there is conflicting evidence as to whether the posterior cruciate ligament should be retained. This study simulated how the posterior cruciate ligament, post-cam mechanism and medial tibial insert morphology may affect postoperative kinematics.<bold>Methods: </bold>After the computational intact knee model was validated according to the motion of a normal knee, four TKA models were built based on a medial pivot prosthesis; PS type, modified PS type, CR type with PCL retained and CR type with PCL sacrificed. Anteroposterior translation and axial rotation of femoral condyles on the tibia during 0°-135° knee flexion were analyzed.<bold>Results: </bold>There was no significant difference in kinematics between the intact knee model and reported data for a normal knee. In all TKA models, normal motion was almost fully restored, except for the CR type with PCL sacrificed. Sacrificing the PCL produced paradoxical anterior femoral translation and tibial external rotation during full flexion.<bold>Conclusion: </bold>Either the posterior cruciate ligament or post-cam mechanism is necessary for medial pivot prostheses to regain normal kinematics after total knee arthroplasty. The morphology of medial tibial insert was also shown to produce a small but noticeable effect on knee kinematics.<bold>Level Of Evidence: </bold>V.
- Subjects
KNEE surgery; POSTERIOR cruciate ligament surgery; POSTERIOR cruciate ligament; ARTIFICIAL joints; BIOLOGICAL models; COMPUTER simulation; RANGE of motion of joints; KINEMATICS; KNEE; TOTAL knee replacement; PHYSIOLOGY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 11, p3375
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3249-1