Abstract
Although total knee arthroplasty (TKA) has become a standard surgical procedure for relieving pain, knowledge of the in vivo knee joint kinematics throughout common functional activities of daily living is still missing. The goal of this study was to analyse knee joint motion throughout complete cycles of daily activities in TKA subjects to establish whether a significant difference in joint kinematics occurs between different activities. Using dynamic videofluoroscopy, we assessed tibio-femoral kinematics in six subjects throughout complete cycles of walking, stair descent, sit-to-stand and stand-to-sit. The mean range of condylar anterior–posterior translation exhibited clear task dependency across all subjects. A significantly larger anterior–posterior translation was observed during stair descent compared to level walking and stand-to-sit. Local minima were observed at approximately 30° flexion for different tasks, which were more prominent during loaded task phases. This characteristic is likely to correspond to the specific design of the implant. From the data presented in this study, it is clear that the flexion angle alone cannot fully explain tibio-femoral implant kinematics. As a result, it seems that the assessment of complete cycles of the most frequent functional activities is imperative when evaluating the behaviour of a TKA design in vivo.
Highlights
Total knee arthroplasty (TKA) has become a standard surgical procedure for relieving pain and restoring function in patients with degenerative joint diseases, mainly osteoarthritis
In order to better understand the mechanisms leading to early failure or an unsatisfactory outcome in general, kinematic and kinetic measures during functional activities of daily living can provide a crucial understanding for further improving the longevity and functionality of TKAs
While numerous studies have investigated joint movement, a fundamental understanding of tibio-femoral kinematics during dynamic and continuous functional activities of daily living remains lacking, mainly due to the limitations of static imaging modalities [15,45] or the soft tissue artefacts associated with skin-marker based techniques [5]
Summary
Total knee arthroplasty (TKA) has become a standard surgical procedure for relieving pain and restoring function in patients with degenerative joint diseases, mainly osteoarthritis. Investigations into TKA function during complete gait cycles using skinmarker-based motion analysis have been successful in determining global segment kinematics, thereby allowing the estimation of external joint moments [2,3,4]. This approach is known to be strongly affected by soft tissue artefacts [5,6] and does not allow an accurate quantification of tibiofemoral antero-posterior (A–P) translation and internal/external rotation [6,7,8,9]. Since these static fluoroscopic systems possess a limited field of view, they are constrained to capturing only very restricted movements of the
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