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Changes in knee kinematics following total knee arthroplasty
Mohsen Akbari Shandiz1, Paul Boulos2, Stefan Karl Saevarsson3
1Biomedical Engineering, University of Calgary, Calgary, AB, Canada McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada moaksh@gmail.com.
Summary
Total knee arthroplasty (TKA) alters knee joint mechanics. Post-surgery, knee kinematics more closely resemble normal motion, though individual variations persist, offering insights for improved implant design and surgical techniques.
Area of Science:
- Orthopedics
- Biomechanics
- Biomedical Engineering
Background:
- Total knee arthroplasty (TKA) significantly alters knee joint mechanics.
- Understanding patellofemoral and tibiofemoral kinematics is crucial for predicting postoperative outcomes, yet remains largely uncharacterized.
- Preoperative and postoperative kinematic analysis can identify causes of poor clinical results after TKA.
Purpose of the Study:
- To identify significant changes in the 6 degrees of freedom of patellofemoral and tibiofemoral kinematics after TKA.
- To evaluate individual variability in kinematic changes following TKA for future patient outcome studies.
- To compare pre-TKA and post-TKA kinematics against normal kinematic data.
Main Methods:
- Prospective study of nine subjects undergoing TKA.
- Weight-bearing 6 degrees of freedom patellofemoral and tibiofemoral kinematics, tibiofemoral contact points, and helical axes of rotation were measured preoperatively and at least one year postoperatively.
- Utilized computed tomography and radiographic imaging systems; compared results to literature values for normal kinematics.
Main Results:
- Significant differences were observed between pre-TKA and post-TKA kinematics, with post-TKA motion being closer to normal.
- Preoperatively, the group's average motion was translational (no pivoting), but individual variations existed; postoperative pivoting also showed considerable variability.
- Flexion behavior was consistently more hinge-like medially and rolling laterally both pre- and postoperatively; helical axes were more consistent postoperatively.
Conclusions:
- Post-TKA kinematics more closely approximate normal knee function compared to preoperative states.
- Significant individual variability in kinematic changes after TKA exists, highlighting the need for personalized outcome analysis.
- A comprehensive understanding of TKA-induced kinematic changes can inform improvements in implant design, patient diagnosis, and surgical techniques.
