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Two different posterior-stabilized mobile-bearing TKA designs: navigator evaluation of intraoperative kinematic differences

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Abstract

Purpose

The purpose of this study was to compare two types of posterior-stabilized (PS) mobile-bearing (MB) total knee arthroplasties (TKAs). The hypothesis was that no major differences were going to be found among the two TKA designs.

Methods

Two cohorts of patients who were divided according to implant design (Cohort A, new design gradually reducing radius PS MB TKA; Cohort B, traditional dual-radius PS MB TKA) were analyzed by means of intraoperative navigation. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during the following kinematic tests: passive range of motion (PROM), varus–valgus stress test at 0° and 30° (VV0, VV30) and anterior/posterior drawer test at 90° of flexion (AP90).

Results

There were no significative differences in kinematic tests between the two implants. Cohort A, however, showed a different post-implant trend for VV0 and VV30 that were lower than the pre-implant ones, as expected, while for Cohort B, the trend is opposite. However, the gradually reducing radius prosthesis (Cohort A) showed a trend of improving stability (29% compared to the preoperative status) in mid-flexion (VV30) which the traditional dual-radius design (Cohort B) would not. Moreover, we found no differences among postoperative results of the two TKA designs.

Conclusion

Despite design variations, no difference has been found among the prostheses in terms of PROM, rotations and translations. Both design kinematics did not show paradoxical external rotations, but an increase in femoral translation in mid-flexion without affecting the functioning of the prosthesis.

Level of evidence

II.

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Funding

The authors declare that they did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subjects of this article.

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Authors and Affiliations

  1. Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    G. M. Marcheggiani Muccioli, S. Fratini, T. Roberti Di Sarsina, S. Di Paolo, A. Grassi, U. Cardinale, E. Cammisa & S. Zaffagnini

  2. Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Bologna, Italy

    S. Zaffagnini

  3. Dipartimento di Scienze per la Qualità della Vita QuVi, Università di Bologna, Bologna, Italy

    L. Bragonzoni

  4. Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy

    T. Ingrassia

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  1. G. M. Marcheggiani Muccioli
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  2. S. Fratini
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  3. T. Roberti Di Sarsina
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  4. S. Di Paolo
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  5. T. Ingrassia
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  6. A. Grassi
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  7. U. Cardinale
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  8. E. Cammisa
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  9. L. Bragonzoni
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  10. S. Zaffagnini
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Correspondence to G. M. Marcheggiani Muccioli.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Marcheggiani Muccioli, G.M., Fratini, S., Roberti Di Sarsina, T. et al. Two different posterior-stabilized mobile-bearing TKA designs: navigator evaluation of intraoperative kinematic differences. Musculoskelet Surg 105, 173–181 (2021). https://doi.org/10.1007/s12306-020-00643-1

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