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Related Experiment Videos

Rotational constraint in posterior-stabilized total knee prostheses.

R Klein1, L Serpe, M A Kester

  • 1Stryker Howmedica Osteonics Corp., Allendale, NJ, USA.

Clinical Orthopaedics and Related Research
|May 29, 2003
PubMed
Summary

Rotational stresses in posterior-stabilized total knee prostheses can cause loosening. Design differences significantly impact torque generation, highlighting the importance of tibiofemoral rotational position for component fixation.

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Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Biomechanics

Background:

  • Loosening of posterior-stabilized total knee prostheses is often linked to rotational stresses from box-post impingement.
  • Understanding the forces generated by tibiofemoral rotation is crucial for improving implant longevity.

Purpose of the Study:

  • To assess and compare the rotational torques generated by two different posterior-stabilized total knee prostheses under simulated physiological loading.
  • To investigate the role of tibiofemoral conformity and box-post impingement in rotational constraint.

Main Methods:

  • A bench model utilizing an axial-torsion load cell was employed to measure rotational torque.
  • Two posterior-stabilized total knee prostheses (Sigma and Scorpio) were tested at varying degrees of flexion (0, 20, 40) and rotation (±20 degrees).

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  • Torque generation was analyzed in relation to tibiofemoral conformity and box-post impingement events.

    • Main Results:

    • The Sigma prosthesis exhibited minimal torque initially, followed by a sharp increase due to box-post impingement, reaching peak torques of 17-18 N-m.
    • The Scorpio prosthesis demonstrated a continuous torque rise from conformity, with no box-post impingement, resulting in 32% lower torque at similar rotation angles.
    • Peak torques for the Scorpio prosthesis were 15-16 N-m at greater rotation (19-20 degrees).

    Conclusions:

    • Tibiofemoral conformity is the primary source of rotational constraint in posterior-stabilized total knee prostheses.
    • Box-post impingement can significantly increase rotational constraint, with design-dependent variations.
    • Small changes in relative tibiofemoral component rotation can drastically alter generated torque, emphasizing the importance of rotational position for component function and fixation in vivo.