Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees

Abstract Purpose The purpose of this study was to analyze the dynamic kinematics of the mobile medial pivot‐type total knee arthroplasty (MMPTKA) using the three‐dimensional (3D)‐to‐2D registration technique. Methods Cadaveric knees from five humans were used. Computed tomography of the lower limb a...

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Main Authors: Osamu Tanifuji, Tomoharu Mochizuki, Takashi Sato, Satoshi Watanabe, Go Omori, Hiroyuki Kawashima
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1186/s40634-022-00558-9
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author Osamu Tanifuji
Tomoharu Mochizuki
Takashi Sato
Satoshi Watanabe
Go Omori
Hiroyuki Kawashima
author_facet Osamu Tanifuji
Tomoharu Mochizuki
Takashi Sato
Satoshi Watanabe
Go Omori
Hiroyuki Kawashima
author_sort Osamu Tanifuji
collection DOAJ
description Abstract Purpose The purpose of this study was to analyze the dynamic kinematics of the mobile medial pivot‐type total knee arthroplasty (MMPTKA) using the three‐dimensional (3D)‐to‐2D registration technique. Methods Cadaveric knees from five humans were used. Computed tomography of the lower limb and preoperative 3D planning for MMPTKA were performed. After performing TKA, passive motion of the knee was observed from a fully extended position to maximum flexion using a flat panel detector. The following parameters were determined: (1) anteroposterior (AP) translations of the medial and lateral most distal points (estimated contact point) of the femoral component, (2) rotational femoral component’s X‐axis (FCX) angle, and (3) rotational insert angle. Paired t‐tests were used to analyze differences in the AP translation between the medial and lateral most distal points of the femoral component as well as differences in the changes in the rotational angle between the FCX and X‐axis of the insert on the tibial component’s axial plane. Results The AP translations of the femoral component’s medial and lateral most distal points were 8.4 ± 2.5 and 13.6 ± 3.3 mm, respectively (p = 0.001). The rotational angles of the FCX and insert were 10.7° ± 4.9° external rotation and 8.9° ± 4.1° internal rotation, respectively (p = 0.004). Conclusions The posterior translation of the lateral side of the femoral component was greater than that of the medial in all cases. Hence, a medial pivot pattern was identified. The femoral component exhibited external rotation throughout knee flexion in all subjects, whereas the mobile insert exhibited internal rotation (opposite pattern relative to the femoral component). This study provides valuable kinematical information of MMPTKA that has not been clear yet.
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spelling doaj-art-7bdb975b04f944aa854aa6a19af241b52025-08-20T02:24:25ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00558-9Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric kneesOsamu Tanifuji0Tomoharu Mochizuki1Takashi Sato2Satoshi Watanabe3Go Omori4Hiroyuki Kawashima5Division of Orthopaedic SurgeryDepartment of Regenerative and Transplant MedicineNiigata University Graduate School of Medicine and Dental Science1‐757 Asahimachi‐Dori Chuo‐Ku951‐8510NiigataJapanDivision of Orthopaedic SurgeryDepartment of Regenerative and Transplant MedicineNiigata University Graduate School of Medicine and Dental Science1‐757 Asahimachi‐Dori Chuo‐Ku951‐8510NiigataJapanDepartment of Orthopaedic SurgeryNiigata Medical CenterNiigataJapanDepartment of Orthopaedic SurgeryNiigata Medical CenterNiigataJapanDepartment of Health and SportsFaculty of Health SciencesNiigata University of Health and WelfareNiigataJapanDivision of Orthopaedic SurgeryDepartment of Regenerative and Transplant MedicineNiigata University Graduate School of Medicine and Dental Science1‐757 Asahimachi‐Dori Chuo‐Ku951‐8510NiigataJapanAbstract Purpose The purpose of this study was to analyze the dynamic kinematics of the mobile medial pivot‐type total knee arthroplasty (MMPTKA) using the three‐dimensional (3D)‐to‐2D registration technique. Methods Cadaveric knees from five humans were used. Computed tomography of the lower limb and preoperative 3D planning for MMPTKA were performed. After performing TKA, passive motion of the knee was observed from a fully extended position to maximum flexion using a flat panel detector. The following parameters were determined: (1) anteroposterior (AP) translations of the medial and lateral most distal points (estimated contact point) of the femoral component, (2) rotational femoral component’s X‐axis (FCX) angle, and (3) rotational insert angle. Paired t‐tests were used to analyze differences in the AP translation between the medial and lateral most distal points of the femoral component as well as differences in the changes in the rotational angle between the FCX and X‐axis of the insert on the tibial component’s axial plane. Results The AP translations of the femoral component’s medial and lateral most distal points were 8.4 ± 2.5 and 13.6 ± 3.3 mm, respectively (p = 0.001). The rotational angles of the FCX and insert were 10.7° ± 4.9° external rotation and 8.9° ± 4.1° internal rotation, respectively (p = 0.004). Conclusions The posterior translation of the lateral side of the femoral component was greater than that of the medial in all cases. Hence, a medial pivot pattern was identified. The femoral component exhibited external rotation throughout knee flexion in all subjects, whereas the mobile insert exhibited internal rotation (opposite pattern relative to the femoral component). This study provides valuable kinematical information of MMPTKA that has not been clear yet.https://doi.org/10.1186/s40634-022-00558-9Total knee arthroplastyKnee kinematicsMobile‐bearingMedial pivotThree‐dimensional to two‐dimensional registration technique
spellingShingle Osamu Tanifuji
Tomoharu Mochizuki
Takashi Sato
Satoshi Watanabe
Go Omori
Hiroyuki Kawashima
Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
Journal of Experimental Orthopaedics
Total knee arthroplasty
Knee kinematics
Mobile‐bearing
Medial pivot
Three‐dimensional to two‐dimensional registration technique
title Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
title_full Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
title_fullStr Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
title_full_unstemmed Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
title_short Mobile medial pivot (lateral slide) type total knee arthroplasty exhibits a medial pivot pattern: three‐dimensional motion analysis using cadaveric knees
title_sort mobile medial pivot lateral slide type total knee arthroplasty exhibits a medial pivot pattern three dimensional motion analysis using cadaveric knees
topic Total knee arthroplasty
Knee kinematics
Mobile‐bearing
Medial pivot
Three‐dimensional to two‐dimensional registration technique
url https://doi.org/10.1186/s40634-022-00558-9
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