Bruce D Beynnon McClure Musculoskeletal Research Center Burlington | United States
J Arthroplasty 2004 Oct;19(7):906-10
Department of Orthopaedics and Rehabilitation, McClure Musculoskeletal Research Center, University of Vermont, Burlington 05405-0084, USA.
Some surgeons warn against kneeling after total knee arthroplasty (TKA), because limited clinical data exist. We describe the tibiofemoral contact position of TKA components during kneeling in vivo. Ten posterior-substituting (PS) and 10 cruciate-retaining (CR) designs were examined using a radiographic image-matching technique. Movement from standing to kneeling at 90 degrees produced different responses. CR knees translated anteriorly (medial, 4 +/- 4 mm; lateral, 2 +/- 6 mm). PS knees underwent little posterior translation (medial, 0.2 +/- 3 mm; lateral, 1 +/- 4 mm). Movement from 90 degrees to maximum flexion produced femoral posterior translation (CR medial, 5 +/- 4 mm; CR lateral, 5 +/- 4 mm; PS medial, 6 +/- 4 mm; PS lateral, 6 +/- 3 mm). The relationship between tibiofemoral contact position and flexion angle was more variable for CR (r2=.38) than for PS (r2=.64). Knee kinematics was similar to other deep-flexion weight-bearing activities.
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