J-curve design total knee arthroplasty: the posterior stabilized shows wider medial pivot compared to the cruciate retai
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KNEE
J‑curve design total knee arthroplasty: the posterior stabilized shows wider medial pivot compared to the cruciate retaining during chair raising Marco Bontempi1 · Tommaso Roberti di Sarsina2 · Giulio Maria Marcheggiani Muccioli2 · Nicola Pizza2 · Umberto Cardinale3 · Laura Bragonzoni4 · Stefano Zaffagnini2 Received: 12 March 2019 / Accepted: 23 July 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose Which total knee arthroplasty (TKA) design represents the better solution to restore a correct knee biomechanics is still debated. The aim of this study was to compare posterior stabilized (PS) and cruciate retaining (CR) version of the same TKA design (femoral component with an anatomic sagittal radius—J-curve design) by the use of dynamic Roentgen stereophotogrammetric analysis (RSA). The hypothesis was that the two models influence differently in vivo knee kinematic. Methods A cohort of 16 randomly selected patients was evaluated 9 months after surgery: Zimmer PERSONA® was implanted, eight with CR design and eight with PS design. The kinematic evaluations were performed using a Dynamic RSA (BI-STAND DRX 2) developed in our Institute, during the execution of the sit-to-stand motor task. The motion parameters were obtained using the Grood and Suntay decomposition and the low-point kinematics methods. Results PS TKA lateral femoral compartment had a wider anterior translation (17 ± 2 mm) than the medial one (11 ± 2 mm), while the two compartments of CR TKA showed a similar anterior translation (medial: 9 ± 2 mm/lateral: 11 ± 2 mm). T test for comparison between CR and PS TKA of antero-posterior translation showed a statistically significant difference (p 40 kg/m2, (5) rheumatoid arthritis, (6) chronic inflammatory joint diseases, (7) patients with a pre-pathological abnormal gait (amputated, neuromuscular disorders, poliomyelitis, developmental dysplasia of the hip), (8) severe ankle osteoarthritis (Kellgren–Lawrence > 3), (9) severe hip osteoarthritis (Kellgren–Lawrence > 3), (10) previous total hip or ankle replacement, and (11) unwilling to take part in study and providing HIPAA authorization. All patients were recruited after signing an informed consent. This study obtained the approval of the Ethics Committee
Knee Surgery, Sports Traumatology, Arthroscopy
of the IRCCS Rizzoli Orthopaedic Institute (IRB statement: 0012645 approved 2014/04/03). Computerized randomization was conducted to allocate them in a proportion of 1:1 either to “PS group” or “CR group”. The patients were divided into groups according to the prosthesis models. Eight PS: five males, three females, six right knees, two left knees, mean age 68 years (95% CI 50–86), average BMI 30. Eight CR: two males, six females, two right knees, six left knees, mean age 67 years (95% CI 55–79), average BMI 26.
Motor task Patients were evaluated at 9-month follow-up (FU). The motor task evaluated for this study was the sit-to-stand: from the sitting position, the patient stands up. The used ch
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