Biomechanical Differences Exhibited During Sit-To-Stand Between Total Knee Arthroplasty Designs of Varying Radii

Wang, He; Simpson, Kathy J.; Ferrara, Michael S.; Chamnongkich, Samatchai; Kinsey, Tracy L.; Mahoney, Ormonde M.

doi:10.1016/j.arth.2006.02.172

Cited by 74 publications

(71 citation statements)

References 11 publications

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“…The sample size of participants in each group was smaller than the typical follow-up studies that report on functional and clinical endpoints. Though sample size plays an important role in interpreting results, we believe from our prior experience with conducting such studies [9,[15][16][17][18], that the sample size chosen was adequate to enable us to make conclusions on our analyses. Additionally, we were able to maintain a similar sample size in each arm of the study.…”

Section: Discussionmentioning

confidence: 99%

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement

Wang

Foster

Franksen

et al. 2017

International Orthopaedics (SICOT)

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Introduction Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/ lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs.The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Methods Twelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking. Results The TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05). Discussion and conclusion This study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.

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Section: Discussionmentioning

confidence: 99%

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement

Wang

Foster

Franksen

et al. 2017

International Orthopaedics (SICOT)

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“…Implant manufacturers have attempted to introduce new prostheses to meet the higher expectations in terms of functional outcomes and patient satisfaction [12]. With the Duracon TKA system now removed from the market, the use of the Triathlon TKA has become favoured by many surgeons [13].…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes comparing Triathlon versus Duracon total knee arthroplasty: does the Triathlon outperform its predecessor?

Palmer

Sloan

Clark

2014

International Orthopaedics (SICOT)

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Purpose Total knee arthroplasty (TKA) prosthesis designs are constantly evolving to obtain greater functional performance. The aim of this study is to compare the functional outcomes between the newer single radius (SR) Triathlon prosthesis with its multiradius (MR) predecessor the Duracon. Method We analysed 1,012 primary TKA procedures which used either the Triathlon SR prosthesis or the Duracon MR prosthesis (338 Triathlon, 674 Duracon). Patients were assessed using the Knee Society score (KSS), range of movement measurements, pain and walking assessments at time points pre-operatively, one year and two years postoperatively. Results Both groups were similar pre-operatively in terms of age, gender and body mass index (BMI). At one year postoperatively the Triathlon group had a significantly better flexion (P=0.005) and KSS (function score P=0.037, knee score P=0.000). At two years postoperatively the Triathlons had maintained a significantly better KSS (function score P=0.046, knee score P=0.000) and also knee flexion (P=0.02). Pain assessments at two years were significantly better in the Triathlon group (P=0.002) with 66.3 % of patients experiencing no pain at that point compared to 54.4 % with Duracon knees. Conclusion This data supports the proposition that the use of Triathlon TKA results in improved outcomes for patients when compared to the Duracon TKA.

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“…We believe the slower stair climbing score is a result of declining strength: stair ascent requires concentric muscle action against gravity repeatedly, while the descent requires eccentric control of the quadriceps. Quadriceps weakness would make this task more challenging; quadriceps function is also influenced by implant design [33,34], thus altering muscle use in the lower extremity. The 6-minute walk score remained stable in both groups; walking requires many muscle groups; this test was originally designed as a measure of respiratory fitness [3], another factor that was not tested in this investigation.…”

Section: Discussionmentioning

confidence: 99%

The Chitranjan Ranawat Award: The Nonoperated Knee Predicts Function 3 Years after Unilateral Total Knee Arthroplasty

Farquhar

Snyder‐Mackler

2010

Clinical Orthopaedics &Amp; Related Research

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The long-term functional abilities of patients after a unilateral total knee arthroplasty (TKA) are influenced by the status of the nonoperated knee at the time of the TKA. We hypothesized that in the 3 years after TKA, the nonoperated limb would become more painful, and the quadriceps muscles would weaken; pain and strength would influence performance on functional testing by 3 years after TKA. Healthy control subjects were tested over the same time interval; we hypothesized the controls would also decline in strength and function over time. Individuals with unilateral knee pain (less than 4/10 on a verbal analog scale) were recruited preoperatively. We tested patients 1, 2, and 3 years after TKA to determine changes in strength, self-report outcome measures, and performance on a stair climbing test and the 6-minute walk test. Control subjects without osteoarthritis were tested twice, 2 years apart. The nonoperated limb of patients with TKA weakened from 1 to 2 years, and further weakened from 2 to 3 years after TKA; by 3 years after TKA, the nonoperated limb was more painful compared to the operated limb. Three years after TKA, nonoperated knee pain contributed 44% of the variability in the 6-minute walk and 33% of the variability in the stair climbing test. Patients with TKA were weaker, slower, and had lower self-report outcome measures compared with control subjects at both time intervals. Control subjects also weakened over time, yet were stable on self-report outcome measures and the 6 minute walk test. Weakening of the quadriceps muscles in all participants represents changes due to ageing; however on average the nonoperated limb weakened over time, possibly representing not only changes resulting from aging, but progression of osteoarthrosis in some patients with unilateral TKA.

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Biomechanical Differences Exhibited During Sit-To-Stand Between Total Knee Arthroplasty Designs of Varying Radii

Cited by 74 publications

References 11 publications

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement

Functional outcomes comparing Triathlon versus Duracon total knee arthroplasty: does the Triathlon outperform its predecessor?

The Chitranjan Ranawat Award: The Nonoperated Knee Predicts Function 3 Years after Unilateral Total Knee Arthroplasty

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