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In vivo kinematics of gait in posterior-stabilized and bicruciate-stabilized total knee arthroplasties using image-matching techniques

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Abstract

Purpose

This study aimed to evaluate the effects of two types of total knee arthroplasty (TKA) designs: posterior-stabilized (PS) and bicruciate-stabilized (BCS) on in vivo kinematics during gait.

Methods

Continuous X-ray images of the gait were taken using a flat panel detector for 23 PS and BCS TKAs. We analyzed the tibiofemoral implant flexion angle, anteroposterior (AP) translation, axial rotation, and anterior/posterior cam-post contact using image-matching techniques.

Results

Double knee actions were demonstrated for the PS and BCS design (35 and 61%, respectively, p = 0.08). The tibiofemoral AP positions were significantly more posterior at peak extension (− 1.7 ± 2.2 and 1.0 ± 2.5 mm, respectively, p < 0.01) and anterior at peak flexion (1.3 ± 2.3 and − 0.8 ± 2.8 mm, respectively, p = 0.01) for the PS design than for the BCS design, with a significant difference in AP translation (3.0 ± 3.9 mm anterior and 1.7 ± 2.8 mm posterior, respectively, p < 0.01). Anterior/posterior tibial post contacts were found in 83/4% and 74/30% for the PS and BCS designs, respectively, with a significant difference in posterior contact (p = 0.72/0.04, respectively).

Conclusion

The knee flexion pattern, tibiofemoral AP translation, axial rotation, and cam-post contact during gait varied, depending on the type of implant, the PS and BCS designs.

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Acknowledgments

This work was supported by a grant from the Kaibara Morikazu Medical Science Promotion Foundation. The authors thank Junji Kishimoto, a statistician from the Digital Medicine Initiative at Kyushu University, for his valuable comments and suggestions regarding the statistical analyses.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Koji Murakami, Satoshi Hamai, Hideki Mizu-uchi, Yukio Akasaki & Yasuharu Nakashima

  2. Department of Orthopaedic Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan

    Ken Okazaki

  3. Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8503, Japan

    Yifeng Wang & Hidehiko Higaki

  4. Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminami-ku, Kitakyushu, Fukuoka, 802-0985, Japan

    Satoru Ikebe

  5. Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan

    Takeshi Shimoto

Authors
  1. Koji Murakami
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Corresponding author

Correspondence to Satoshi Hamai.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by Institutional Review Board of Kyushu University (IRB number 24-166). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Murakami, K., Hamai, S., Okazaki, K. et al. In vivo kinematics of gait in posterior-stabilized and bicruciate-stabilized total knee arthroplasties using image-matching techniques. International Orthopaedics (SICOT) 42, 2573–2581 (2018). https://doi.org/10.1007/s00264-018-3921-z

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