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Design and kinematics in total knee arthroplasty
Vitantonio Digennaro1, Francesco Zambianchi, Andrea Marcovigi
1Department of Orthopaedic Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio-Emilia, Via del Pozzo, 71, 41124, Modena, Italy, digennaro_1977@libero.it.
International Orthopaedics
|January 15, 2014
Summary
The Journey Bi-Cruciate Stabilised (BCS) total knee arthroplasty (TKA) demonstrated superior clinical outcomes compared to the Scorpio NRG design. Enhanced posterior femoral rollback in the BCS design is linked to better patient results, influencing TKA performance.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Knee Biomechanics
Background:
- Posterior stabilised (PS) total knee arthroplasty (TKA) designs aim to restore normal knee kinematics.
- Existing PS fixed-bearing designs exhibit variations in posterior femoral rollback and axial rotation.
- Understanding kinematic patterns is crucial for optimizing TKA clinical and functional outcomes.
Purpose of the Study:
- To compare the clinical and functional outcomes of two guided-motion total knee systems: Scorpio NRG and Journey Bi-Cruciate Stabilised (BCS).
- To investigate the influence of kinematic patterns on patient outcomes following TKA.
Main Methods:
- Retrospective comparative study of 347 patients who underwent TKA with either Scorpio NRG or Journey BCS.
- Clinical evaluation using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire for 281 patients.
- Video fluoroscopy analysis of knee kinematics during functional tasks for a subset of patients (15 Scorpio NRG, 16 Journey BCS) at six months.
Main Results:
- Journey BCS TKAs showed significantly better KOOS results at an average 29-month follow-up.
- The Journey BCS group exhibited greater posterior femoral rollback (10-18 mm) compared to the Scorpio NRG group (2-3 mm).
- Anterior knee pain was reported in the Scorpio NRG group, while stiffness was more frequent in the Journey BCS group.
Conclusions:
- The Journey BCS design, with its enhanced posterior femoral rollback and potentially superior patellofemoral design, leads to better clinical outcomes.
- Excessive tibiofemoral translation in TKA designs may contribute to stiffness and anterolateral joint pain.
- Prosthetic bearing geometry and kinematic patterns significantly influence TKA clinical-functional outcomes and complication rates.
