Pre-clinical assessment of total knee replacement anterior-posterior constraint
File(s)Manuscript revised March 2018.docx (2.33 MB)
Accepted version
Author(s)
Halewood, Camilla
Athwal, KK
Amis, Andrew
Type
Journal Article
Abstract
Pre-clinical, bench-top assessment of Total Knee Replacements (TKR) can provide information about the inherent constraint provided by a TKR, which does not depend on the condition of the patient undergoing the arthroplasty. However little guidance is given by the ASTM standard on test configurations such as medial-lateral (M:L) loading distribution, flexion angle or restriction of secondary motions. Using a purpose built rig for a materials testing machine, four TKRs currently in widespread clinical use, including medial-pivot and symmetrical condyle types, were tested for anterior-posterior translational constraint. Compressive joint loads from 710 to 2000 N, and a range of medial-lateral (M:L) load distributions, from 70:30% to 30:70% M:L, were applied at different flexion angles with secondary motions unconstrained. It was found that TKA constraint was significantly less at 60 and 90° flexion than at 0°, whilst increasing the compressive joint load increased the force required to translate the tibia to limits of AP constraint at all flexion angles tested. Additionally when M:L load distribution was shifted medially, a coupled internal rotation was observed with anterior translation and external rotation with posterior translation. This paper includes some recommendations for future development of pre-clinical testing methods.
Date Issued
2018-05-17
Date Acceptance
2018-03-23
Citation
Journal of Biomechanics, 2018, 73, pp.153-160
ISSN
0021-9290
Publisher
Elsevier
Start Page
153
End Page
160
Journal / Book Title
Journal of Biomechanics
Volume
73
Copyright Statement
© 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Subjects
Science & Technology
Life Sciences & Biomedicine
Technology
Biophysics
Engineering, Biomedical
Engineering
TKR
TKA
Constraint
Laxity
ARTHROPLASTY
STABILITY
MOBILITY
0903 Biomedical Engineering
1106 Human Movement And Sports Science
0913 Mechanical Engineering
Biomedical Engineering
Publication Status
Published
Date Publish Online
2018-03-30