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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Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Total Knee Arthroplasty Without Patellar Component Replacement. Does it Increase the Risk of Revision? Local Experience Analysis ePoster Presentation Zoy Anastasiadis, MD, CHILE Diego Edwards, MD, CHILE Sergio Arellano, MD, CHILE Andrés Schmidt-Hebbel, MD, CHILE Eduardo Gardella, MD, CHILE Nicolás González-Kusjanovic, MD, MSc, CHILE Alex Vaisman, MD, Prof., CHILE
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Palliative Arthroscopic Debridement with Continuous Irrigation for the Infection TKA of High Mortality Risk Patients ePoster Presentation Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Yoon Cheol Nam, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF
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 Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
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
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments? ePoster Presentation Ashok Kumar Podhili Subramani, MS, INDIA Shantanu S. Patil, MBBS, MS(Orth), INDIA SAWAN PAWAR, MBBS MS (ORTH), INDIA Kalaivanan Kanniyan, MBBS MS Orth, INDIA karthik jayachandran, MS, INDIA PICHAI SURYANARAYAN, MBBS MS ORTH, 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