Intra-operative navigation of knee kinematics and the influence of osteoarthritis

Abstract

Intra-operative assessment of knee kinematics should optimise implantation of total knee arthroplasties. The purpose of this work was to validate the data delivered by an adapted navigation system in 10 healthy cadaver knees and to investigate the kinematics of 10 osteoarthritic (OA) knees in patients undergoing total knee replacement. The system displayed the magnitude of axial rotation, the position of the instantaneous centre of axial rotation and the displacements of the condyles. Successive cycles from full extension to 140° of flexion in the same knee produced a mean external rotation of 20° ± 10°, which was correlated to knee flexion (r=0.6 ± 0.2 in healthy knees, r=0.8 ± 0.2 in OA knees). The centre of axial rotation migrated posteriorly an average of 8.2mm in both groups. The posterior displacements were 4 mm ± 5 mm in healthy and 5 mm ± 6 mm in OA knees for the medial condyle, and 21 mm ± 9 mm in healthy and 21 mm ± 10 mm in OA knees for the lateral condyle. The medial condyle lifted off beyond 110° of flexion. Results in healthy knees were consistent with those reported in the current literature. The kinematics of healthy and of OA knees with an intact anterior cruciate ligament did not differ significantly.