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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Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, UNITED STATES
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umito Kuwashima, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Deepak Gupta, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, 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
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA ePoster Presentation Manabu Akagawa, MD, PhD, JAPAN ヒデトモサイトウ, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study ePoster Presentation Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS, INDIA

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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