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Updated: May 27, 2026

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
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Construction-conditioned rollback in total knee replacement: fluoroscopic results.

Martin Michael Wachowski1, Christoph Fiedler, Tim Alexander Walde

  • 1Department of Trauma Surgery, Plastic and Reconstructive Surgery, University of Göttingen, Germany. martin.wachowski@web.de

Acta of Bioengineering and Biomechanics
|November 22, 2011
PubMed
Summary

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This study introduces a novel cam gear mechanism for total knee replacement (TKR) that mimics natural knee rollback, reducing friction during gait. In vivo measurements show similar patella tendon angles to native knees.

Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Biomechanics

Background:

  • Total knee replacement (TKR) aims to restore natural knee function, but replicating the tibiofemoral joint (TFJ) kinematics remains a challenge.
  • Existing TKR designs may not fully replicate the rollback motion of the native TFJ, potentially affecting gait mechanics and implant longevity.

Purpose of the Study:

  • To describe the implementation of a cam gear mechanism in the AEQUOS G1 TKR to approximate natural tibiofemoral joint rollback.
  • To analyze the geometric design, kinematics, and functional properties of this novel TKR mechanism.
  • To present in vivo fluoroscopic measurements of the patella tendon angle during flexion/extension.

Main Methods:

  • Geometric design of medial and lateral articulating surfaces to create a positive-drive cam gear mechanism under force closure.

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  • Analysis of construction-conditioned kinematical and functional properties during flexion/extension.
  • In vivo fluoroscopic measurements of the patella tendon angle in relation to knee flexion during gait (0°-60°).

    • Main Results:

    • The cam gear mechanism ensures predominantly rolling motion of articulating surfaces during the stance phase, minimizing sliding friction and reducing resistance.
    • In vivo measurements demonstrated that the patella tendon angle/knee flexion angle characteristic closely resembles that of a native knee during gait.
    • The observed kinematic profile aligns with natural knee function within the tested flexion range (0°-60°).

    Conclusions:

    • The implemented cam gear mechanism effectively approximates natural tibiofemoral joint rollback in the AEQUOS G1 TKR.
    • This design reduces friction during the stance phase of gait, potentially improving patient mobility and implant performance.
    • The in vivo kinematic data supports the functional similarity of the TKR to the native knee in the early to mid-flexion range.