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Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty
Author(s) -
Cromie Melinda J.,
Siston Robert A.,
Giori Nicholas J.,
Delp Scott L.
Publication year - 2008
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20664
Subject(s) - posterior cruciate ligament , prosthesis , anterior cruciate ligament , medicine , femur , tibia , total knee arthroplasty , orthodontics , arthroplasty , anatomy , kinematics , surgery , physics , classical mechanics
Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20–60°) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1 ± 4.3 mm to 10.4 ± 5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2 ± 9.6° to 49.3 ± 7.3°). Implanting the prosthesis increased the amount of anterior translation (to 16.1 ± 4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0–60°) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1494–1499, 2008