Document Detail

Robotic testing of proximal tibio-fibular joint kinematics for measuring instability following total knee arthroplasty.
MedLine Citation:
PMID:  20665552     Owner:  NLM     Status:  MEDLINE    
Pain secondary to instability in total knee arthroplasty (TKA) has been shown to be major cause of early failure. In this study, we focused on the effect of instability in TKA on the proximal tibio-fibular joint (PTFJ). We used a robotics model to compare the biomechanics of the PTFJ in the native knee, an appropriately balanced TKA, and an unbalanced TKA. The tibia (n = 5) was mounted to a six-degree-of-freedom force/torque sensor and the femur was moved by a robotic manipulator. Motion at the PTFJ was recorded with a high-resolution digital camera system. After establishing a neutral position, loading conditions were applied at varying flexion angles (0°, 30°, and 60°). These included: internal/external rotation (0 Nm, ±5 Nm), varus/valgus (0 Nm, ±10 Nm), compression (100 N, 700 N), and posterior drawer (0 N, 100 N). With respect to anterior displacement, external rotation had the largest effect (coefficient = 0.650; p < 0.0001). Polyethylene size as well as the interaction between polyethylene size and flexion consistently showed substantial anterior motion. Flexion and mid-flexion instability in TKA have been difficult to quantify. While tibio-femoral kinematics is the main aspect of TKA performance, the effects on adjacent tissues should not be overlooked. Our data show that PTFJ kinematics are affected by the balancing of the TKA.
Wael K Barsoum; Ho H Lee; Trevor G Murray; Robb Colbrunn; Alison K Klika; S Butler; Antonie J van den Bogert
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of orthopaedic research : official publication of the Orthopaedic Research Society     Volume:  29     ISSN:  1554-527X     ISO Abbreviation:  J. Orthop. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-11     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8404726     Medline TA:  J Orthop Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  47-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Orthopaedic Research Society.
Department of Orthopaedic Surgery - A41, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
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MeSH Terms
Arthroplasty, Replacement, Knee*
Fibula / physiology
Joint Instability / physiopathology*
Knee Joint / physiology*
Tibia / physiology
Grant Support
#1P30 AR-050953/AR/NIAMS NIH HHS; P30 AR050953-049003/AR/NIAMS NIH HHS; P30 AR050953-05/AR/NIAMS NIH HHS; P30 AR050953-059003/AR/NIAMS NIH HHS

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