Approximation of the functional kinematics of posterior stabilised total knee replacements using a two-dimensional sagittal plane patello-femoral model: comparing model approximation to in vivo measurement

Bernard Van Duren, Hemant Pandit, David Murray, Harinderjit Gill

Research output: Contribution to journalArticlepeer-review

3 Citations (SciVal)

Abstract

Previous in vivo studies have observed that current designs of posterior stabilised (PS) total knee replacements (TKRs) may be ineffective in restoring normal kinematics in Late flexion. Computer-based models can prove a useful tool in improving PS knee replacement designs. This study investigates the accuracy of a two-dimensional (2D) sagittal plane model capable of predicting the functional sagittal plane kinematics of PS TKR implanted knees against direct in vivo measurement. Implant constraints are often used as determinants of anterior-posterior tibio-femoral positioning. This allowed the use of a patello-femoral modelling approach to determine the effect of implant constraints. The model was executed using motion simulation software which uses the constraint force algorithm to achieve a solution. A group of 10 patients implanted with Scorpio PS implants were recruited and underwent fluoroscopic imaging of their knees. The fluoroscopic images were used to determine relative implant orientation using a three-dimensional reconstruction method. The determined relative tibio-femoral orientations were then input to the model. The model calculated the patella tendon angles (PTAs) which were then compared with those measured from the in vivo fluoroscopic images. There were no significant differences between the measured and calculated PTAs. The average root mean square error between measured and modelled ranged from 1.17° to 2.10° over the flexion range. A sagittal plane patello-femoral model could conceivably be used to predict the functional 2D kinematics of an implanted knee joint. This may prove particularly useful in optimising PS designs.
Original languageEnglish
Pages (from-to)1191-1199
Number of pages9
JournalComputer Methods in Biomechanics and Biomedical Engineering
Volume18
Issue number11
Early online date24 Feb 2014
DOIs
Publication statusPublished - 2015

Keywords

  • arthroplasty
  • kinematics
  • knee
  • modelling
  • TKA
  • TKR

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