New posterior-stabilized rotating-platform TKA design partially restores normal knee kinematic both during activity of daily living and high demanding motor task
ESSKA Academy. Zaffagnini S. 11/08/19; 284383; epEKA-48 Topic: Joint Replacement
Prof. Dr. Stefano Zaffagnini
Prof. Dr. Stefano Zaffagnini
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New posterior-stabilized rotating-platform TKA design partially restores normal knee kinematic both during activity of daily living and high demanding motor task

ePoster - epEKA-48

Topic: TKA

Marcheggiani Muccioli G.M.1, Pizza N.1, Di Paolo S.1, Zinno R.1, Bragonzoni L.2, Bontempi M.2, Agostinone P.1, Roberti Di Sarsina T.1, Zaffagnini S.1
1IRCCS Istituto Ortopedico Rizzoli, II Orthopaedic and Traumatologic Clinic, Bologna, Italy, 2Università di Bologna, Bologna, Italy

Introduction: Rotating Platform (RP) total knee arthroplasty (TKA) design has been introduced with the primary goal to improve knee kinematics after TKA. The purpose of the present study was to compare the kinematical behavior of one of the most commonly implanted TKA RP design during an activity of daily living (Sit-To-Stand - STS) and a high demanding task (Deep-Knee-Lunge - DKL) using Dynamic RSA.
Objectives: The kinematical behavior of the TKA would not be different during the two motor tasks.
Aims: Detect TKAs kinematical patterns and attempt to forecast long-term survivorship pattern and clinical outcomes.
Methods: A cohort of 25 randomly selected patients were recruited after signing an informed consent validated by Rizzoli Institute IRB and were prospectively evaluated. The PS RP TKA was implanted. At minimum 9 months follow-up (FU), patients were examined with model based Dynamic RSA during the execution of the two motor tasks. The kinematic parameters were obtained with the Grood and Suntay decomposition. The Pearson's coefficient was used to assess the correlation between STS and the extension phase of the lunge. Correlation statistically significant set if p< 0.05.
Results: All 25 patients performed the STS, 22 the DKL.
Antero-Posterior translation (AP): femur anteriorly translates from 80°to 30°of flexion (6±0.5mm; significantly correlated, p< 0.0001).From 30° of flexion to full extension (no significant correlation).
Internal-External rotations (IE): femur internally rotates from 80°to 30°of flexion (4±0.5°; significantly correlated, p< 0.0001). From 30° of flexion to full extension (no significant correlation)
low-point contact positions of medial and lateral femoral compartment (LP): no differences between medial and lateral compartment during STS nor lunge extension.
Conclusions: STS and Lunge extension are highly correlated. LP demonstrated that the TKA did not fully restored the screw home mechanism, despite the femoral component internally rotates and anteriorly translates during extension. This is due to the polyethylene inlay characteristics. Most of the rotation occur between the rotating inlay and the tibial component, while the femoral compartments move with the same trend. This specific TKA RP design is able to partially restore normal knee kinematic both in activity of daily living and high demanding task.
New posterior-stabilized rotating-platform TKA design partially restores normal knee kinematic both during activity of daily living and high demanding motor task

ePoster - epEKA-48

Topic: TKA

Marcheggiani Muccioli G.M.1, Pizza N.1, Di Paolo S.1, Zinno R.1, Bragonzoni L.2, Bontempi M.2, Agostinone P.1, Roberti Di Sarsina T.1, Zaffagnini S.1
1IRCCS Istituto Ortopedico Rizzoli, II Orthopaedic and Traumatologic Clinic, Bologna, Italy, 2Università di Bologna, Bologna, Italy

Introduction: Rotating Platform (RP) total knee arthroplasty (TKA) design has been introduced with the primary goal to improve knee kinematics after TKA. The purpose of the present study was to compare the kinematical behavior of one of the most commonly implanted TKA RP design during an activity of daily living (Sit-To-Stand - STS) and a high demanding task (Deep-Knee-Lunge - DKL) using Dynamic RSA.
Objectives: The kinematical behavior of the TKA would not be different during the two motor tasks.
Aims: Detect TKAs kinematical patterns and attempt to forecast long-term survivorship pattern and clinical outcomes.
Methods: A cohort of 25 randomly selected patients were recruited after signing an informed consent validated by Rizzoli Institute IRB and were prospectively evaluated. The PS RP TKA was implanted. At minimum 9 months follow-up (FU), patients were examined with model based Dynamic RSA during the execution of the two motor tasks. The kinematic parameters were obtained with the Grood and Suntay decomposition. The Pearson's coefficient was used to assess the correlation between STS and the extension phase of the lunge. Correlation statistically significant set if p< 0.05.
Results: All 25 patients performed the STS, 22 the DKL.
Antero-Posterior translation (AP): femur anteriorly translates from 80°to 30°of flexion (6±0.5mm; significantly correlated, p< 0.0001).From 30° of flexion to full extension (no significant correlation).
Internal-External rotations (IE): femur internally rotates from 80°to 30°of flexion (4±0.5°; significantly correlated, p< 0.0001). From 30° of flexion to full extension (no significant correlation)
low-point contact positions of medial and lateral femoral compartment (LP): no differences between medial and lateral compartment during STS nor lunge extension.
Conclusions: STS and Lunge extension are highly correlated. LP demonstrated that the TKA did not fully restored the screw home mechanism, despite the femoral component internally rotates and anteriorly translates during extension. This is due to the polyethylene inlay characteristics. Most of the rotation occur between the rotating inlay and the tibial component, while the femoral compartments move with the same trend. This specific TKA RP design is able to partially restore normal knee kinematic both in activity of daily living and high demanding task.
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