Summary
A goal of knee replacement is to achieve normal function and kinematics. One solution is to preserve all of the ligaments and use compartmental components. However, if complete resurfacing is indicated, one or both of the cruciates is usually resected, and dished bearing surfaces are used to replace their function. Intercondylar cams can be added to ensure posterior femoral contacts in high flexion. In this paper, an alternative scheme is presented where the bearing surfaces are not simple combinations of radii but are based on converging or diverging mediallateral bearing spacing as flexion proceeds. This scheme produces natural roll-back with flexion, more pronounced on the lateral side, while preserving the laxity which is characteristic of the normal knee. It is proposed that this design can produce natural knee kinematics which may result in close to normal function.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Akagi M et al (2000) The bisurface total knee replacement: a unique design for flexion. J Bone Joint Surg [Am] 82:1626–1633
Ateshian GA et al (1991) Quantitation of articular surface topography and cartilage thickness in knee joints using stereophotogrammetry. J Biomech 24:761–776
Ateshian GA (2003) Topography of knee femoral articular surface. (Personal communication)
Blankevoort L et al (1988) The envelope of passive knee joint motion. J Biomech 21:705–720
Buechel FF (2002) Long-term follow-up after mobile bearing total knee replacement. Clin Orthop 404:40–50
Callaghan CM et al (1995) Patient outcomes following unicompartmental or bicompartmental knee arthroplasty: a meta-analysis. J Arthroplasty 10:141–50
Cohen ZA et al (2003) Templates of the cartilage layers of the patellofemoral joint and their use in the assessment of osteoarthritic cartilage damage. Osteoarthritis Cartilage 11:569–579
Draganich L et al (1998) TRAC PS knee design and clinical outcome. Abstracts Book, Annual Symposium of the Int Soc for Technology in Arthroplasty. Marseille, pp 96–99
Ewald FC (1974) Joint prostheses. United States Patent, number 3798679, March
Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop 248:9–12
Feikes JD et al (1998) The unique track of intact passive knee motion as a kinematic baseline. Trans Orthop Res Soc 23:170
Haider H, Walker PS (2005) Measurements of constraint of total knee replacement. J Biomech 38:341–348
Hill PF et al (2000) Tibiofemoral movement. II: The loaded and unloaded knee studied by MRI. J Bone Joint Surg [Br] 82:1196–1198
Insall JH, Clarke HD (2001) Historic development, classification, and characteristics of knee prostheses. In: Insall JH (ed) Surgery of the knee, 3rd edn. Chap 73, vol 2, pp 1516–1552
Iwaki H et al (2000) Tibiofemoral movement. I: The shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg [Br] 82:1189–1195
Li G, Zayontz et al (2003) Kinematics of the knee at high flexion angles. J Orthop Res 22:90–95
Luger E et al (1997) Inherent differences in the laxity and stability between the intact knee and total knee replacements. Knee 4:7–14
MacWilliams BA et al (1999) Hamstrings co-contraction reduces internal rotation, anterior translation, and anterior cruciate ligament load in weight-bearing flexion. J Orthop Res 17:817–822
Murray DG et al (1982) The variable axis prosthesis: 2-year follow-up study. J Bone Joint Surg [Am] 63:687–694
Nakagawa S et al (2000) Tibiofemoral movement: full flexion in the living knee studied by MRI. J Bone Joint Surg [Br] 82:1199–2000
Rovick JS et al (1991) Relation between knee motion and ligament length patterns. Clin Biomech 6:213–220
Sathasivam S et al (1997) A computer model with surface friction for the prediction of total knee kinematics. J Biomech 30:177–184
Sathasivam S et al (1999) The conflicting requirements of laxity and conformity in total knee replacement. J Biomech 32:239–247
Seedhom BB et al (1974) The Leeds knee. Proc Institution of Mechanical Engineers, London, Symposium on Total Knee Replacement. CP16:108–114
Thompson WO et al (1991) Tibial meniscus dynamics using threedimensional reconstruction of the magnetic resonance images. Am J Sports Med 19:210–216
Walker PS et al (1974) Proc Institution of Mechanical Engineers, London, Symposium on Total Knee Replacement. CP16: 22–29
Walker PS (1991) Design of Kinemax total knee replacement bearing surfaces. Acta Orthop Belg 57:108–113
Walker PS et al (1999) The design of guide surfaces for fixed-bearing and mobile-bearing knee replacements. J Biomech 32:27–34
Walker PS et al (2000) Controlling the Motion of total knee replacement using intercondylar guide surfaces. J Orthop Res 18:48–55
Walker PS (2001) A new concept in guided motion total knee arthroplasty. J Arthroplasty 16:157–163
Walker PS et al (2003) Characterising the motion of total knee replacements in laboratory tests. Clin Orthop 410:54–68
Weiss JM et al (2002) What functional activities are important to patients with knee replacements? Clin Orthop 404:172–188
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer Medizin Verlag Heidelberg
About this chapter
Cite this chapter
Walker, P.S. (2005). Bearing Surfaces for Motion Control in Total Knee Arthroplasty. In: Bellemans, J., Ries, M.D., Victor, J.M. (eds) Total Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27658-0_47
Download citation
DOI: https://doi.org/10.1007/3-540-27658-0_47
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-20242-4
Online ISBN: 978-3-540-27658-6
eBook Packages: MedicineMedicine (R0)