Influence of total knee replacement (TKR) design on screw-home movement: Comparison of five designs for total knee replacement prostheses |
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Authors: | Yoshinori Ishii Kazuhiro Terajima Yoshio Koga Hideaki Takahashi Joan E. Bechtold |
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Affiliation: | (1) Department of Orthopaedic Surgery, Gyoda Hospital, 376 Mochida, 361 Gyoda, Saitama, Japan;(2) Niigata University Mechanical Engineering, 8050 Nino-cho, 950-21 Igarashi, Niigata, Japan;(3) Niigata Kobari Hospital, 3-27-11 Kobari, 950-21 Niigata, Japan;(4) Niigata University School of Medicine, 757 Ichiban-cho, 951 Asahimachi-dori, Niigata, Japan;(5) Hennepin County Medical Center, Minneapolis, MN, USA |
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Abstract: | We evaluated the effect of surface geometry and retention of the posterior cruciate ligament (PCL) on screw-home movement in the knees of patients fitted with total knee replacement prostheses of five different designs (Miller/Galante [Zimmer, Warsaw, IN, USA], Mark II [Mizuho, Tokyo, Japan], Genesis PCL retaining, and cruciate substituting [Smith & Nephew/Richards, Memphis, TN, USA], and Yoshino/Shoji II [Biomet, Wiltshire, UK]). Three-dimensional motion was measured with a six-degree-of-freedom electrogoniometer (our original) during active flexion and extension of the knee. The Genesis-PCL retaining design, which has symmetric femoral and asymmetric tibial components, exhibited a pattern of screw-home movement closest to that in a normal control group (continuous external rotation between 30° flexion and extension). The implants with symmetric tibial components and the Genesis PCL-substituting design, with its asymmetric tibial articulating surface, did not replicate the screw-home movement. An asymmetric tibial articulating surface and retention of the PCL in total knee replacement may be important factors in allowing screw-home movement to occur. |
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Keywords: | total knee replacement prosthetic design screw-home movement |
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