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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"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
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
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
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
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Use of Tibial Stem for Patients with Morbid Obesity in Total Knee Arthroplasty ePoster Presentation José Eduardo Flores Naranjo, MD, MEXICO Adrian Aziz Cortes De La Fuente, MD, MEXICO Octavio Martinez Montiel, MD, MEXICO Fernando Martinez Zuñiga, MD, MEXICO
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
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
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, 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
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES

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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