Abstract
IntroductionNewer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs.The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls.MethodsTwelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking.ResultsThe TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05).Discussion and conclusionThis study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.
Highlights
Introduction Newertotal knee replacement (TKR) designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs
This study examined knee strength and mechanics during walking in patients who have either a Persona TKR or an iDuo bi-compartmental knee replacement (BKR), as compared to healthy controls
There were no differences in age between the BKR and TKR groups (p = 0.62) or between the BKR and control groups (p = 0.09)
Summary
Introduction NewerTKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Patients with oversized/undersized TKRs may hesitate to exert full effort during knee exercises and weight-bearing activities, which could negatively affect the pace of post-operative recovery. The asymmetric tibial component aims to eliminate the compromise between rotation and fit These improvements could result in an improved feel and function for patients while performing weight-bearing activities such as walking. To date, it is not known how much of an improvement in knee strength and function patients could gain after implantation with this design
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