Kinematically aligned total knee arthroplasty limits high tibial forces, differences in tibial forces between compartments, and abnormal tibial contact kinematics during passive flexion

Purpose Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee functi...

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Published inKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 26; no. 6; pp. 1589 - 1601
Main Authors Roth, Joshua D., Howell, Stephen M., Hull, Maury L.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2018
John Wiley & Sons, Inc
Subjects
Aged
Aged, 80 and over
Alignment
Arthroplasty (knee)
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
Biomechanical Phenomena
Biomedical materials
Bone Malalignment - etiology
Bone Malalignment - physiopathology
Bone Malalignment - prevention & control
Cadaver
Cadavers
Compartments
Femoral components
Femur
Human performance
Humans
Joint surgery
Kinematics
Knee
Knee Joint - physiopathology
Knee Joint - surgery
Knee Prosthesis
Medical personnel
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Range of Motion, Articular
Recovery of function
Surgery
Surgical implants
Tibia - physiopathology
Tibia - surgery
Tibial components
Translation
Tibial force sensor
Kinematic alignment
Anterior sliding
Soft tissue balancing
Intra-articular load
Contact force imbalance
Tibiofemoral joint
Online AccessGet full text
ISSN0942-2056
1433-7347
1433-7347
DOI10.1007/s00167-017-4670-z

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Abstract Purpose Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion. Methods Using cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor. Results The average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p  = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm ( p  < 0.0001) and 18 mm ( p  < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion. Conclusions After kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.
AbstractList Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion.PURPOSEFollowing total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion.Using cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor.METHODSUsing cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor.The average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm (p < 0.0001) and 18 mm (p < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion.RESULTSThe average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm (p < 0.0001) and 18 mm (p < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion.After kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.CONCLUSIONSAfter kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.
Purpose Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion. Methods Using cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor. Results The average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p  = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm ( p  < 0.0001) and 18 mm ( p  < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion. Conclusions After kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.
PurposeFollowing total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion.MethodsUsing cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor.ResultsThe average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm (p < 0.0001) and 18 mm (p < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion.ConclusionsAfter kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.
Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion indicate abnormal knee function. Because the goal of kinematically aligned TKA is to restore native knee function without soft tissue release, the objectives were to determine how well kinematically aligned TKA limits high tibial forces, differences in tibial forces between compartments, and anterior translation of the contact locations of the femoral component on the tibial component during passive flexion. Using cruciate retaining components, kinematically aligned TKA was performed on thirteen human cadaveric knee specimens with use of manual instruments without soft tissue release. The tibial forces and tibial contact locations were measured in both the medial and lateral compartments from 0° to 120° of passive flexion using a custom tibial force sensor. The average total tibial force (i.e. sum of medial + lateral) ranged from 5 to 116 N. The only significant average differences in tibial force between compartments occurred at 0° of flexion (29 N, p = 0.0008). The contact locations in both compartments translated posteriorly in all thirteen kinematically aligned TKAs by an average of 14 mm (p < 0.0001) and 18 mm (p < 0.0001) in the medial and lateral compartments, respectively, from 0° to 120° of flexion. After kinematically aligned TKA, average total tibial forces due to the soft tissue restraints were limited to 116 N, average differences in tibial forces between compartments were limited to 29 N, and a net posterior translation of the tibial contact locations was observed in all kinematically aligned TKAs during passive flexion from 0° to 120°, which are similar to what has been measured previously in native knees. While confirmation in vivo is warranted, these findings give surgeons who perform kinematically aligned TKA confidence that the alignment method and surgical technique limit high tibial forces, differences in tibial forces between compartments, and anterior translation of the tibial contact locations during passive flexion.
Author Howell, Stephen M.
Hull, Maury L.
Roth, Joshua D.
Author_xml – sequence: 1
  givenname: Joshua D.
  surname: Roth
  fullname: Roth, Joshua D.
  organization: Biomedical Engineering Graduate Group, University of California, Davis
– sequence: 2
  givenname: Stephen M.
  surname: Howell
  fullname: Howell, Stephen M.
  organization: Biomedical Engineering Graduate Group, University of California, Davis, Department of Biomedical Engineering, University of California, Davis
– sequence: 3
  givenname: Maury L.
  surname: Hull
  fullname: Hull, Maury L.
  email: mlhull@ucdavis.edu
  organization: Biomedical Engineering Graduate Group, University of California, Davis, Department of Biomedical Engineering, University of California, Davis, Department of Mechanical and Aerospace Engineering, University of California, Davis, Department of Orthopaedic Surgery, University of California, Davis
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28884312$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017
Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, (2017). All Rights Reserved.
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IngestDate Fri Sep 05 09:13:34 EDT 2025
Fri Jul 25 20:12:27 EDT 2025
Thu Apr 03 07:05:09 EDT 2025
Tue Jul 01 02:59:37 EDT 2025
Thu Apr 24 23:03:15 EDT 2025
Fri Feb 21 02:37:31 EST 2025
IsPeerReviewed true
IsScholarly true
Issue 6
Keywords Tibial force sensor
Kinematic alignment
Anterior sliding
Soft tissue balancing
Intra-articular load
Contact force imbalance
Tibiofemoral joint
Language English
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PublicationDate 20180600
2018-6-00
2018-Jun
20180601
PublicationDateYYYYMMDD 2018-06-01
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PublicationPlace Berlin/Heidelberg
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PublicationTitle Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
PublicationTitleAbbrev Knee Surg Sports Traumatol Arthrosc
PublicationTitleAlternate Knee Surg Sports Traumatol Arthrosc
PublicationYear 2018
Publisher Springer Berlin Heidelberg
John Wiley & Sons, Inc
Publisher_xml – name: Springer Berlin Heidelberg
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SSID ssj0005649
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Snippet Purpose Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and...
Following total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and anterior...
PurposeFollowing total knee arthroplasty (TKA), high tibial forces, large differences in tibial forces between the medial and lateral compartments, and...
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StartPage 1589
SubjectTerms Aged
Aged, 80 and over
Alignment
Arthroplasty (knee)
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
Biomechanical Phenomena
Biomedical materials
Bone Malalignment - etiology
Bone Malalignment - physiopathology
Bone Malalignment - prevention & control
Cadaver
Cadavers
Compartments
Femoral components
Femur
Human performance
Humans
Joint surgery
Kinematics
Knee
Knee Joint - physiopathology
Knee Joint - surgery
Knee Prosthesis
Medical personnel
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Range of Motion, Articular
Recovery of function
Surgery
Surgical implants
Tibia - physiopathology
Tibia - surgery
Tibial components
Translation
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Title Kinematically aligned total knee arthroplasty limits high tibial forces, differences in tibial forces between compartments, and abnormal tibial contact kinematics during passive flexion
URI https://link.springer.com/article/10.1007/s00167-017-4670-z
https://www.ncbi.nlm.nih.gov/pubmed/28884312
https://www.proquest.com/docview/2043018586
https://www.proquest.com/docview/1937527260
Volume 26
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