Abstract
BackgroundDissimilar total knee arthroplasty implant designs offer different functional characteristics. This is the first work in the literature to fully assess the Columbus ultra-congruent mobile (UCR) system with a rotating platform.MethodsThis is a double-blinded randomised controlled trial, comparing the functional performance of the low congruent fixed (CR DD), ultra-congruent fixed (UC) and UCR Columbus Total Knee Systems. The pre-operative and post-operative functional performance of twenty-four osteoarthritic patients was evaluated against nine control participants when carrying out everyday tasks. Spatiotemporal, kinematic and kinetic gait parameters in walking and stair navigation were extracted by means of motion capture.ResultsThe UC implant provided better post-operative function, closely followed by the UCR design. However, both the UC and UCR groups exhibited restricted post-operative sagittal RoM (walking, 52.1 ± 4.4° and 53.2 ± 6.6°, respectively), whilst patients receiving a UCR implant did not show an improvement in their tibiofemoral axial rotation despite the bearing’s mobile design (walking, CR DD 13.2 ± 4.6°, UC 15.3 ± 6.7°, UCR 13.5 ± 5.4°). Patients with a CR DD fixed bearing showed a statistically significant post-operative improvement in their sagittal RoM when walking (56.8 ± 4.6°).ConclusionIt was concluded that both ultra-congruent designs in this study, the UC and UCR bearings, showed comparable functional performance and improvement after TKA surgery. The CR DD group showed the most prominent improvement in the sagittal RoM during walking.Trial registrationThe study is registered under the clinical trial registration number: NCT02422251. Registered on April 21, 2015.
Highlights
Dissimilar total knee arthroplasty implant designs offer different functional characteristics
Advancements in the design of total knee arthroplasty (TKA) prostheses have led to the commercialisation of more than 150 types of knee implants [1] with potentially different functions
To further explore whether implant design paradigm variations result in significant differences, this study evaluates the full biomechanical performance of three different bearing configurations of Columbus knee replacement implants and the age-matched natural knee; the hypothesis being that the mobile high congruent bearing will facilitate more natural movements during everyday tasks
Summary
Dissimilar total knee arthroplasty implant designs offer different functional characteristics. This is the first work in the literature to fully assess the Columbus ultra-congruent mobile (UCR) system with a rotating platform. Advancements in the design of total knee arthroplasty (TKA) prostheses have led to the commercialisation of more than 150 types of knee implants [1] with potentially different functions. Urwin et al [18] reported no significant differences between fixed (Sigma® Fixed Bearing Knee System, De Puy International) and mobile bearings (Sigma® Rotating Platform Knee System, DePuy International) in spatiotemporal, kinematic and kinetic measurements (stride length and time, gait velocity, flexion angles during walking, knee RoM and maximum knee adduction moment) at 9 months post-operatively. TKA patients in the same study walked with greater minimum knee flexion and reduced knee adduction moment when compared to the control group
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