PMID- 7501878
OWN - NLM
STAT- MEDLINE
DCOM- 19960117
LR  - 20161123
IS  - 0035-1040 (Print)
IS  - 0035-1040 (Linking)
VI  - 81
IP  - 3
DP  - 1995
TI  - [Cinematic in vivo analysis of the knee: a comparative study of 4 types of total 
      knee prostheses].
PG  - 198-210
AB  - PURPOSE OF THE STUDY: The goal of the study was to assess in vivo kinematics for 
      four designs of knee prosthesis during level walking, stair climbing and non 
      weight-bearing flexion-extension. PATIENT AND METHODS: 19 patients with 
      unilateral total knee arthroplasty (TKA) were included [5 bicruciate sparing 
      prosthesis (BI), 5 posterior cruciate sparing prosthesis with flat tibial 
      polyethylene (PP), 5 posterior cruciate sparing prosthesis with congruent tibial 
      polyethylene (PC), 4 postero stabilised (PS)]. These 19 patients had no 
      prosthesis nor pathological situation in any other joint of the lower limbs. Each 
      of these 19 prosthesis had an HSS score greater than 80 and no radiographic signs 
      of loosening. Magnitudes of the knee rotations (flexion-extension axial rotation 
      valgus-varus) were evaluated with a 6 degrees freedom of motion 
      electromagnetic-goniometer during level walking, stair climbing and non 
      weight-bearing flexion-extension. The magnitudes of the three rotations were 
      recorded for the 19 prosthetic knees and for the 19 controlateral non prosthetic 
      knees of the patients. Reproducibility of the method was also evaluated on 12 
      healthy subjects by comparison of magnitudes observed during two different 
      recordings. RESULTS: Reproducibility was excellent for magnitudes of flexion (r = 
      0.95/p = 0.0001) and axial rotation (r = 0.55/p = 0.002) but less satisfactory 
      for valgus-varus movements (r = 0.46/p = 0.005). The magnitudes of the three 
      rotations were inferior for TKA in comparison with healthy knees for any 
      activities. By comparison of the 19 prosthetic and non prosthetic knees we 
      recorded smaller magnitudes of axial rotation during swing phase for level and 
      stair climbing and during non weight-bearing flexion extension movements. Between 
      the four kind of prosthesis we observed: greater magnitudes of flexion for BI and 
      PC prosthesis during stair climbing (p < 0.05) and greater magnitudes of flexion 
      for BI PC and PS prosthesis during stair descending (p < 0.05). PC prosthesis 
      instead of a congruent polyethylene tibial plateau had greater magnitudes of 
      axial rotation than non constrained BI prosthesis during stair climbing (p = 
      0.009). In spite of a high femoro-tibial congruency we recorded axial rotation in 
      PS prosthesis during each activities. DISCUSSION AND CONCLUSION: Our method 
      evaluating in vivo knee kinematics was reproducible. These four knee prosthetic 
      designs in spite of a good functional results were unable to reproduce magnitudes 
      of movements recorded in healthy subjects. The small number of prosthesis 
      included in the study prompt us to consider as no definitive the differences 
      observed between the 4 designs. Anyway the influence of design on kinematics 
      should be considered as relative since we recorded axial rotation for all four 
      cruciate substituting prostheses although they had high femoro-tibial congruency. 
      Influence of femoro-tibial congruency and cruciate ligament sparing could be 
      assessed in vivo by means of this reproducible method on a larger population.
FAU - Migaud, H
AU  - Migaud H
AD  - Service d'Orthopedie-Traumatologie B, Hopital B, C.H.R.U. de Lille.
FAU - Gougeon, F
AU  - Gougeon F
FAU - Diop, A
AU  - Diop A
FAU - Lavaste, F
AU  - Lavaste F
FAU - Duquennoy, A
AU  - Duquennoy A
LA  - fre
PT  - Comparative Study
PT  - Journal Article
TT  - Analyse in vivo de la cinematique du genou: comparaison de quatre types de 
      protheses totales.
PL  - France
TA  - Rev Chir Orthop Reparatrice Appar Mot
JT  - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur
JID - 1272427
SB  - IM
MH  - Adult
MH  - Biomechanical Phenomena
MH  - Cineradiography
MH  - Data Interpretation, Statistical
MH  - Female
MH  - Humans
MH  - Knee Joint/diagnostic imaging/*physiology
MH  - *Knee Prosthesis
MH  - Male
MH  - Mathematics
MH  - Middle Aged
MH  - *Range of Motion, Articular
MH  - Reproducibility of Results
EDAT- 1995/01/01 00:00
MHDA- 1995/01/01 00:01
CRDT- 1995/01/01 00:00
PHST- 1995/01/01 00:00 [pubmed]
PHST- 1995/01/01 00:01 [medline]
PHST- 1995/01/01 00:00 [entrez]
AID - MDOI-RCO-05-1995-81-3-0035-1040-101019-BKR64 [pii]
PST - ppublish
SO  - Rev Chir Orthop Reparatrice Appar Mot. 1995;81(3):198-210.