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Kinematics and early migration in single-radius mobile- and fixed-bearing total knee prostheses

机译:单半径活动和固定轴承全膝关节假体的运动学和早期迁移

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摘要

Background The mobile-bearing variant of a single-radius design is assumed to provide more freedom of motion compared to the fixed-bearing variant because the insert does not restrict the natural movements of the femoral component. This would reduce the contact stresses and wear which in turn may have a positive effect on the fixation of the prosthesis to the bone and thereby decreases the risk for loosening. The aim of this study was to evaluate early migration of the tibial component and kinematics of a mobile-bearing and fixed-bearing total knee prosthesis of the same single-radius design. Methods Twenty Triathlon single-radius posterior-stabilized knee prostheses were implanted (9 mobile-bearing and 11 fixed-bearing). Fluoroscopy and roentgen stereophotogrammetric analysis (RSA) were performed 6 and 12 months post-operatively. Findings The 1 year post-operative RSA results showed considerable early migrations in 3 out of 9 mobile-bearing patients and 1 out of 11 fixed-bearing patients. The range of knee flexion was the same for the mobile-bearing and fixed-bearing group. The mobile insert was following the femoral component during motion. Interpretation Despite the mobile insert following the femoral component during motion, and therefore performing as intended, no kinematic advantages of the mobile-bearing total knee prosthesis were seen. The fixed-bearing knee performed as good as the mobile-bearing knee and maybe even slightly better based on less irregular kinematics and less early migrations.
机译:背景技术由于固定件不限制股骨组件的自然运动,因此与固定轴承的变体相比,单半径设计的移动轴承的变体被认为提供了更多的运动自由度。这将减少接触应力和磨损,这反过来又可能对将假体固定在骨骼上产生积极影响,从而降低了松动的风险。这项研究的目的是评估胫骨组件的早期迁移以及具有相同单半径设计的活动式和固定式全膝关节假体的运动学。方法植入20个铁人三项单半径后路稳定膝关节假体(9个活动支撑和11个固定支撑)。术后6个月和12个月进行荧光检查和伦氏立体摄影测量分析(RSA)。研究结果术后1年的RSA结果显示,在9例活动性患者中有3例在早期迁移,在11例固定性患者中有1例在早期迁移。膝关节屈曲的范围与活动支撑组和固定支撑组相同。运动期间,可移动插入物跟随股骨组件。解释尽管在运动过程中可移动插入物跟随股骨组件运动,因此按预期执行,但未见可移动轴承的全膝关节假体的运动学优势。固定支撑膝关节的表现与活动支撑膝关节一样好,基于较少的不规则运动学和较少的早期迁移,膝关节的表现可能甚至更好。

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