Summary: The EVOLUTION® Medial-Pivot knee arthroplasty showed that, during flexion in weight-bearing, a medial pivot motion was seen at higher reproducibility, which is consistent with the implant design intent.

Introduction

Total knee arthroplasty (TKA) is the most effective surgical treatment for patients with severe osteoarthritis of the knee. The physiological motion of the normal knee joint shows a posterior sliding of the lateral femoral condyle on the tibial plateau while a pivoting movement on the medial compartment. One of the main goals of TKA implant design is to produce kinematics at least similar to such normal knee. The Medial-Pivot (MP) TKA has been developed to replicate the medial pivot motion seen in the normal knee by modifying the joint geometry. However, it is still somewhat controversial as to whether or not this MP implant can actually reliably reproduce such desired kinematics in vivo.
The purpose of the present study is to examine the three-dimensional in-vivo kinematics in the MP TKA during weight-bearing activity.

Materials And Methods

A total of 18 consecutive patients (10 women and 8 men) who required a unilateral TKA for severe medial knee osteoarthritis were enrolled in this study. All knees had been implanted with Evolution® Medial-Pivot Knee and cruciate-substituting insert (MicroPort Orthopedics Inc., Arlington, TN, USA). At one year after surgery, all patients were examined clinically and analyzed in-vivo kinematics during lunge and step-up activities using fluoroscopy. In kinematic analysis, anteroposterior movement of medial and lateral femoral condyles (MFC and LFC) on the tibial tray, tibial axial rotation relative to the femoral component, and center of rotation were measured using a 2D/3D registration technique.

Results

Postoperatively, all patients had pain relief and well-functioning knee in daily life. The average postoperative ROM was 120.6 ± 9.5°. During both activities, the amount of anterior movement of MFC was less than 0.5 mm showing a constant position on the medial tibial tray. On the other hand, LFC moved posteriorly up to 5 mm on the lateral tibial tray as flexion increased. The averaged tibial internal rotation angle was approximately 4° from extension to flexion. The femoral component showed a medial pivot pattern in 15 knees (83%) and 13 knees (72%) during lunge and step-up activities, respectively.

Conclusion

The knees implanted with EVOLUTION® MP knee arthroplasty showed at higher reproducibility, during flexion in weight-bearing, a medial pivot motion with a stable AP contact position of MFC and rollback of LFC. Such in-vivo kinematics is consistent with the implant design intent, in spite of the magnitude in tibial internal rotation less than the normal knee.
There are some limitations in the present study. First, this study is a study with small sample size in postoperative early phase. Further studies with larger samples in longer follow-up period are needed.

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Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Efficacy of Functional Alignment Technique In Robotic-Arm Assisted Total Knee Arthroplasty ePoster Presentation Masashi Tamaki, MD, PhD, JAPAN Yuki Yamauchi, MD,PhD, JAPAN Seishiro Higa, MD, JAPAN Tomoyuki Shimakawa, MD, JAPAN Yuki Isobe, MD, JAPAN Teruya Ishibashi, MD,PhD, JAPAN Shoji Konda, PhD, JAPAN Tetsuya Tomita, M.D.,Ph.D , JAPAN
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY

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In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity

In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity

Introduction

Materials And Methods

Results

Conclusion

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In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity

In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity

Introduction

Materials And Methods

Results

Conclusion

More 2023 ISAKOS Congress Content