Open AccessRestoration of normal knee kinematics with respect to tibial insert design in mobile bearing lateral unicompartmental arthroplasty using computational simulation
Author(s) -
YongGon Koh,
Jin-Ah Lee,
Hyun-Seok Chung,
Hyo-Jeong Kim,
KyoungTak Kang
Publication year - 2020
Publication title -
bone and joint research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.639
H-Index - 31
ISSN - 2046-3758
DOI - 10.1302/2046-3758.97.bjr-2019-0384.r1
Subject(s) - unicompartmental knee arthroplasty , kinematics , insert (composites) , total knee arthroplasty , computational simulation , orthodontics , osteoarthritis , medicine , engineering , computer science , surgery , mechanical engineering , physics , alternative medicine , classical mechanics , pathology , computational science
Aims Mobile-bearing unicompartmental knee arthroplasty (UKA) with a flat tibial plateau has not performed well in the lateral compartment, leading to a high rate of dislocation. For this reason, the Domed Lateral UKA with a biconcave bearing was developed. However, medial and lateral tibial plateaus have asymmetric anatomical geometries, with a slightly dished medial and a convex lateral plateau. Therefore, the aim of this study was to evaluate the extent at which the normal knee kinematics were restored with different tibial insert designs using computational simulation.Methods We developed three different tibial inserts having flat, conforming, and anatomy-mimetic superior surfaces, whereas the inferior surface in all was designed to be concave to prevent dislocation. Kinematics from four male subjects and one female subject were compared under deep knee bend activity.Results The conforming design showed significantly different kinematics in femoral rollback and internal rotation compared to that of the intact knee. The flat design showed significantly different kinematics in femoral rotation during high flexion. The anatomy-mimetic design preserved normal knee kinematics in femoral rollback and internal rotation.Conclusion The anatomy-mimetic design in lateral mobile UKA demonstrated restoration of normal knee kinematics. Such design may allow achievement of the long sought normal knee characteristics post-lateral mobile UKA. However, further in vivo and clinical studies are required to determine whether this design can truly achieve a more normal feeling of the knee and improved patient satisfaction. Cite this article: Bone Joint Res 2020;9(7):421–428.