Abstract
We examined the relative motion of femoral and tibial total knee arthroplasty components and the difference between 2 different tibial inserts (9 flat types and 7 dish types) in patients sitting in very deep flexion. X-ray, fluoroscopic examination, and computed tomography were used to analyze liftoff, and rotation. During seiza-style sitting, one knee (11%) with the flat insert lifted off on the medial side and 5 knees (71%) with the dish-type insert showed liftoff. The tibial internal rotation angles were 17.2° ± 4.1° (flat type) and 11.7° ± 3.1° (dish type) ( P < .05). The flat type showed less liftoff at the medial side and more internal rotation. For very deep flexion, components that tolerate larger rotational freedom are favorable.
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