Comparison between the kinematics of fixed and rotating bearing knee prostheses

Rotating platform mobile bearing knee implants allow for increased tibiofemoral articular conformity without restricting axial rotation. In the current study, the effect of rotating platform knee replacement with and without posterior cruciate ligament substitution on knee kinematics was investigated. Five knees were implanted sequentially implanted with standard (fixed) bearings and then with rotating platform prostheses, each in posterior cruciate retaining and substituting designs. Three-dimensional kinematics for all knees were measured in an Oxford Knee Rig, which simulates dynamic quadriceps-driven closed kinetic chain knee extension under load. Rotating bearings did not significantly change knee kinematics when compared with fixed bearings. In this in vitro model, the cruciate retaining designs stayed more anterior, and had greater net femoral roll back and tibiofemoral valgus angulation with flexion than cruciate substituting designs.