Reduction in tibiofemoral conformity in lateral unicompartmental knee arthroplasty is more representative of normal knee kinematics

Bone & Joint Research

article

Yong-Gon Koh¹  Jin-Ah Lee²  Hwa-Yong Lee²  Hyo-Jeong Kim³  Hyun-Seok Chung¹  Kyoung-Tak Kang² 

[1] Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital;Department of Mechanical Engineering, Yonsei University;Department of Sport and Healthy Aging, Korea National Sport University

关键词: Unicompartmental knee arthroplasty;    Tibial insert;    Finite element method;   

DOI  :  10.1302/2046-3758.812.BJR-2019-0114.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsCommonly performed unicompartmental knee arthroplasty (UKA) is not designed for the lateral compartment. Additionally, the anatomical medial and lateral tibial plateaus have asymmetrical geometries, with a slightly dished medial plateau and a convex lateral plateau. Therefore, this study aims to investigate the native knee kinematics with respect to the tibial insert design corresponding to the lateral femoral component.MethodsSubject-specific finite element models were developed with tibiofemoral (TF) and patellofemoral joints for one female and four male subjects. Three different TF conformity designs were applied. Flat, convex, and conforming tibial insert designs were applied to the identical femoral component. A deep knee bend was considered as the loading condition, and the kinematic preservation in the native knee was investigated.ResultsThe convex design, the femoral rollback, and internal rotation were similar to those of the native knee. However, the conforming design showed a significantly decreased femoral rollback and internal rotation compared with that of the native knee (p < 0.05). The flat design showed a significant difference in the femoral rollback; however, there was no difference in the tibial internal rotation compared with that of the native knee.ConclusionThe geometry of the surface of the lateral tibial plateau determined the ability to restore the rotational kinematics of the native knee. Surgeons and implant designers should consider the geometry of the anatomical lateral tibial plateau as an important factor in the restoration of native knee kinematics after lateral UKA.

【 授权许可】

CC BY-NC