Restoration of normal knee kinematics with respect to tibial insert design in mobile bearing lateral unicompartmental arthroplasty using computational simulation

Bone & Joint Research

article

Yong-Gon Koh¹  Jin-Ah Lee²  Hyun-Seok Chung¹  Hyo-Jeong Kim³  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;    Lateral tibiofemoral conformity;    Computational study;   

DOI  :  10.1302/2046-3758.97.BJR-2019-0384.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsMobile-bearing unicompartmental knee arthroplasty (UKA) with a flat tibial plateau has not performed well in the lateral compartment, leading to a high rate of dislocation. For this reason, the Domed Lateral UKA with a biconcave bearing was developed. However, medial and lateral tibial plateaus have asymmetric anatomical geometries, with a slightly dished medial and a convex lateral plateau. Therefore, the aim of this study was to evaluate the extent at which the normal knee kinematics were restored with different tibial insert designs using computational simulation.MethodsWe developed three different tibial inserts having flat, conforming, and anatomy-mimetic superior surfaces, whereas the inferior surface in all was designed to be concave to prevent dislocation. Kinematics from four male subjects and one female subject were compared under deep knee bend activity.ResultsThe conforming design showed significantly different kinematics in femoral rollback and internal rotation compared to that of the intact knee. The flat design showed significantly different kinematics in femoral rotation during high flexion. The anatomy-mimetic design preserved normal knee kinematics in femoral rollback and internal rotation.ConclusionThe anatomy-mimetic design in lateral mobile UKA demonstrated restoration of normal knee kinematics. Such design may allow achievement of the long sought normal knee characteristics post-lateral mobile UKA. However, further in vivo and clinical studies are required to determine whether this design can truly achieve a more normal feeling of the knee and improved patient satisfaction.

【 授权许可】

CC BY-NC