Article

Deficiencies in contemporary posterior crucitate retaining knee
included inadequate femoral rollback and insufficient tibial rotation. Current
study attempted to restore normal femoral rollback and tibial rotation to
facilitate in knee flexion/extension and to achieve appropriate posture at deep
knee bending after total knee arthroplasy by mimicking the morphology of convexly
lateral tibial plateau of intact knee. METHODS:
Computational simulation was
utilized to analyze motion of three-dimensional knee models, including intact,
traditionally symmetrical posterior crucitate retaining and newly anatomic-like
posterior crucitate retaining knees. Solid bones, attachments of ligaments and
tendons of simulation models were reconstructed by magnetic resonance images of
the subject. According to the representative literature, the distal femur was
modeled to rotate about the specific axes and the motion of the proximal tibial
was unconstrained except for the flexion/extension. Movements of the
medial/lateral condyles and tibial rotation were recorded and analyzed. FINDINGS:
The newly anatomic-like posterior crucitate retaining knee improved the posterior
movement of lateral condyle and tibial internal rotation significantly during
full range of flexion. Compared with traditionally symmetrical posterior
crucitate retaining knee, the improvements displayed by newly developed posterior
crucitate retaining knee in posterior movement of lateral condyle and tibial
internal rotation were 11.2mm and 9.3 degrees at full flexion, respectively.
INTERPRETATION: The newly anatomic-like posterior crucitate retaining knee
demonstrated that mimicking the morphology of convexly lateral tibial plateau can
be expected to restore normal knee kinematics.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS