Comparison of finite helical axes of normal and anatomically designed prosthetic knees
Comparison of finite helical axes of normal and anatomically designed prosthetic knees
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DOI：
10.1016/j.clinbiomech.2019.03.018
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发表时间：
2019-05-01
影响因子：
1.8
通讯作者：
Sugamoto, Kazuomi
中科院分区：
文献类型：
--
作者：
Konda, Shoji;Tomita, Tetsuya;Sugamoto, Kazuomi
背景资料：用有限螺旋轴描述三维关节运动有利于理解人工膝关节中未知的耦合运动。我们的目的是研究的差异，正常和解剖设计的交叉保留和后稳定型假体膝关节全膝关节置换术后，有限螺旋轴的方向：10个正常，40个交叉保留型假体膝关节的33例和19个后稳定型假体膝关节的14例患者进行了分析，使屈曲> 120 °，在蹲运动与深屈膝关节。通过荧光成像系统记录运动，并通过图像配准技术确定骨和假体的姿势。使用30度窗口计算有限螺旋轴。正常膝关节屈曲早期的有限螺旋轴向下倾斜较大（平均-19.0度（SD 7.2度））（平均-1.7（SD 5.0度））和后稳定型（平均-2.9度（SD 5.5度））假体膝关节（p < 0.001），并且在中度至深度屈曲阶段变得几乎水平和恒定。相反，交叉韧带保留和后稳定的假体膝关节表现出轻微的倾斜，几乎恒定的垂直角在所有phases.Interpretation：这些结果表明，在正常的膝盖，一个明确的耦合运动发生在早期屈曲阶段。对于交叉韧带保留型和后稳定型假体膝关节，在所有阶段都存在不明确的耦合运动。这些结果表明，即使在解剖学设计的假肢膝关节中，仅使用形状引导运动也不可能再现生理运动。
Background: Describing three-dimensional joint motion using the finite helical axis has an advantage in understanding unknown coupling motion in prosthetic knee joints. We aimed to examine the differences in the orientations of finite helical axis of normal and anatomically designed cruciate-retaining and posterior-stabilized prosthetic knees after total knee arthroplasty.Methods: Ten normal, 40 cruciate-retaining prosthetic knees of 33 patients and 19 posterior-stabilized prosthetic knees of 14 patients enabling to flex > 120 degrees were analyzed during a squatting motion with deep knee bending. The motion was recorded by a fluoroscopic imaging system, and the pose of the bone and prostheses were determined by an image registration technique. The finite helical axes were calculated using 30 degrees window.Findings: The finite helical axis in the early flexion phase of the normal knees had a greater inferior inclination (mean - 19.0 degrees (SD 7.2 degrees)) than those of the cruciate-retaining (mean -1.7 (SD 5.0 degrees)) and posterior-stabilized (mean - 2.9 degrees (SD 5.5 degrees)) prosthetic knees (p < 0.001), and became almost horizontal and constant in the mid to deep flexion phases. In contrast, the cruciate-retaining and posterior-stabilized prosthetic knees demonstrated slightly inclined and almost constant vertical angles throughout the all phases.Interpretation: These results demonstrate that, in the normal knee, a clear coupling motion occurs during the early flexion phase. For the cruciate-retaining and posterior-stabilized prosthetic knees, an unclear coupling motion exists during all phases. These results suggest that the physiological motion is not possible to reproduce using shape-guided motion only even in an anatomically designed prosthetic knee.