Abstract
Alterations in native knee kinematics in medial unicompartmental knee arthroplasty (UKA) are caused by the nonanatomic articular surface of conventional implants. Technology for an anatomy mimetic patient-specific (PS) UKA has been introduced. However, there have been no studies on evaluating the preservation of native knee kinematics with respect to different prosthetic designs in PS UKA. The purpose of this study was to evaluate the preservation of native knee kinematics with respect to different UKA designs using a computational simulation. We evaluated three different UKA designs: a nonconforming design, an anatomy mimetic design, and a conforming design for use under gait and squat loading conditions. The results show that the anatomy mimetic UKA design achieves closer kinematics to those of a native knee compared to the other two UKA designs under such conditions. The anatomy memetic UKA design exhibited a 0.39 mm and 0.36° decrease in the translation and rotation, respectively, in the swing phase compared with those of the natural knee. In addition, under the gait and squat loading conditions, the conforming UKA design shows limited kinematics compared to the nonconforming UKA design. Our results show that the conformity of each component in PS UKA is an important factor in knee joint kinematics; however, the anatomy mimetic UKA design cannot restore perfect native kinematics.
Highlights
Unicompartmental knee arthroplasty (UKA) in patients with isolated medial osteoarthritis (OA) in a knee joint is known to be a standard procedure leading to good postoperative results [1]
The kinematics in PS UKA designs with three different conformities were compared with the validated normal knee under gait cycle and squat loading conditions
Internal rotation of the tibia was greater in normal knee than that in the three PS UKA models up to 1.4° additional internal rotation of the tibia in the 80% of the stance phase, which was predicted in the three PS UKA models during gait cycle loading condition
Summary
Unicompartmental knee arthroplasty (UKA) in patients with isolated medial osteoarthritis (OA) in a knee joint is known to be a standard procedure leading to good postoperative results [1]. Reliable clinical results during the first decade of use encouraged surgeons to expand the application of UKA to younger and more active patients [2, 3]. There are several main advantages of UKA compared to total knee arthroplasty (TKA). UKA has the benefit of both preserving the cruciate ligaments and delivering normal-like kinematics compared to the TKA [7]. The results of UKA at 10 years have become competitive to those reported for TKA [8]
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