gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Translational and rotational knee joint stability in bi-compartmental anterior and posterior cruciate-retaining knee arthroplasty

Meeting Abstract

  • M. Wünschel - Universitätsklinikum Tübingen, Orthopädische Abteilung, Tübingen, Germany
  • J. Lo - Universitätsklinikum Tübingen, Orthopädische Abteilung, Tübingen, Germany
  • O. Müller - Universitätsklinikum Tübingen, Orthopädische Abteilung, Tübingen, Germany
  • T. Dilger - Universitätsklinikum Tübingen, Orthopädische Abteilung, Tübingen, Germany
  • N. Wülker - Universitätsklinikum Tübingen, Orthopädische Abteilung, Tübingen, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN12-646

DOI: 10.3205/10dkou087, URN: urn:nbn:de:0183-10dkou0876

Veröffentlicht: 21. Oktober 2010

© 2010 Wünschel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The anterior cruciate ligament (ACL) is sacrificed in the majority of total knee arthroplasty (TKA) surgeries, whereas TKA is currently performed either with preservation or with substitution of the posterior cruciate ligament (PCL). The rationale for retaining the PCL in the TKA design includes that it enhances stability, reproduces more physiological tibiofemoral kinematics, decreases shear force between implant-bone interface, and maintains the proprioception. Theoretically, similar advantages may be provided by the bicruciate-retaining bi-compartmental Knee Arthroplasty (BKA) design. Therefore, the objective of the current study was to investigate passive translational and rotational stability properties of the natural knee joint, with bicruciate-retaining BKA and with posterior cruciate retaining TKA. We hypothesized that, comparing to the native knee, the joint laxities in anterior-posterior translation, internal-external rotation, and valgus-varus rotation are not affected after (a) an bicruciate-retaining BKA or (b) an ACL- sacrificing (PCL-Retaining) TKA.

Methods: Fourteen human cadaveric knee specimens were used in this study as well as a robotic manipulator with six-axis force/torque sensor was used to test the joint laxity in anterior-posterior translation, valgus-varus, and internal-external rotation.

After the coordinate systems of the knee specimen had been determined, a so-called passive path was then generated and learned by the robotic manipulator which was then recorded in the robotic system to serve as a baseline knee flexion path. A 130 N of anterior and posterior tibial force, 5 Nm of internal, external, valgus, and varus tibial torques were applied on the same knee specimen, and the resulting laxity values were determined in the corresponding loading directions. All these laxity tests were performed at each 15 degree between 0 and 90 degree of knee flexion. These trials were performed on the intact knee joint, after bicruciate-retaining BKA and after posterior cruciate retaining TKA in the same specimen

Results and Conclusions: The results show that the knee joint stability after bicruciate-retaining BKA in anterior-posterior, internal-external, and valgus-varus directions is similar to that of the native knee. On the other hand, the PCL-retaining TKA results in inferior joint stability in valgus, varus, external rotation, anterior and posterior directions.

Our findings suggest that, provided functional ligamentous structures, bicruciate-retaining BKA is a biomechanically attractive and reasonable treatment for bicompartimental joint degenerative disease.