Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees

Elise C Pegg, Francesco Mancuso, Mona Alinejad, Bernard H van Duren, John J O'Connor, David W Murray, Hemant G Pandit

Research output: Contribution to journalArticle

2 Citations (Scopus)
67 Downloads (Pure)

Abstract

BACKGROUND: There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients.

METHODS: The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame.

FINDINGS: The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability, particularly from 40-60° of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38% longer to perform the exercises.

INTERPRETATION: Kinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient.

Original languageEnglish
Pages (from-to)33-39
JournalClinical Biomechanics
Volume31
DOIs
Publication statusPublished - Jan 2016

Fingerprint

Knee Replacement Arthroplasties
Anterior Cruciate Ligament
Biomechanical Phenomena
Knee
Patellar Ligament
Exercise
Fluoroscopy
Survival Rate

Cite this

Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees. / Pegg, Elise C; Mancuso, Francesco; Alinejad, Mona; van Duren, Bernard H; O'Connor, John J; Murray, David W; Pandit, Hemant G.

In: Clinical Biomechanics, Vol. 31, 01.2016, p. 33-39.

Research output: Contribution to journalArticle

Pegg, Elise C ; Mancuso, Francesco ; Alinejad, Mona ; van Duren, Bernard H ; O'Connor, John J ; Murray, David W ; Pandit, Hemant G. / Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees. In: Clinical Biomechanics. 2016 ; Vol. 31. pp. 33-39.
@article{e40c4adfa5c24c8bb70fee5b812a0934,
title = "Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees",
abstract = "BACKGROUND: There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients.METHODS: The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame.FINDINGS: The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability, particularly from 40-60° of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38{\%} longer to perform the exercises.INTERPRETATION: Kinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient.",
author = "Pegg, {Elise C} and Francesco Mancuso and Mona Alinejad and {van Duren}, {Bernard H} and O'Connor, {John J} and Murray, {David W} and Pandit, {Hemant G}",
note = "Crown Copyright {\circledC} 2015. Published by Elsevier Ltd. All rights reserved.",
year = "2016",
month = "1",
doi = "10.1016/j.clinbiomech.2015.10.004",
language = "English",
volume = "31",
pages = "33--39",
journal = "Clinical Biomechanics",
issn = "0268-0033",
publisher = "Elsevier",

}

TY - JOUR

T1 - Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees

AU - Pegg, Elise C

AU - Mancuso, Francesco

AU - Alinejad, Mona

AU - van Duren, Bernard H

AU - O'Connor, John J

AU - Murray, David W

AU - Pandit, Hemant G

N1 - Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

PY - 2016/1

Y1 - 2016/1

N2 - BACKGROUND: There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients.METHODS: The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame.FINDINGS: The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability, particularly from 40-60° of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38% longer to perform the exercises.INTERPRETATION: Kinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient.

AB - BACKGROUND: There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients.METHODS: The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame.FINDINGS: The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability, particularly from 40-60° of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38% longer to perform the exercises.INTERPRETATION: Kinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient.

UR - http://dx.doi.org/10.1016/j.clinbiomech.2015.10.004

U2 - 10.1016/j.clinbiomech.2015.10.004

DO - 10.1016/j.clinbiomech.2015.10.004

M3 - Article

VL - 31

SP - 33

EP - 39

JO - Clinical Biomechanics

JF - Clinical Biomechanics

SN - 0268-0033

ER -