In vivo comparisons of patellofemoral kinematics before and after ADVANCE Medial-Pivot total knee arthroplasty

Int Orthop. 2012 Oct;36(10):2073-7. doi: 10.1007/s00264-012-1634-2. Epub 2012 Aug 11.

Abstract

Purpose: ADVANCE Medial-Pivot (MP) (Wright Medical Technology, Arlington, TN, USA) total knee arthroplasty (TKA) was developed to replicate normal tibiofemoral knee joint kinematics, allowing medial-pivot knee motion. The design concept of the prosthesis is unique; therefore, the influence on the patellofemoral knee joint remains unclear at present. The purpose of this study was to determine the in vivo patellofemoral kinematics with ADVANCE MP TKA and compare them with the pre-operative conditions.

Methods: ADVANCE MP TKA was performed in ten subjects with osteoarthritis (OA). At before and one month after surgery, lateral radiographs with weight-bearing at maximum extension, 30, 60 and 90° were taken, and patella flexion angle (PF), tibiopatellar angle (TP) and estimated patellofemoral contact point (PC) were evaluated, according to a previously reported method.

Results: In PF and TP, there was no statistically significant change between pre-operative and postoperative values. Pre-operative PC reached its peak at 90°; however, its peak was at 60° at one month after surgery. Postoperative PC at maximum extension was significantly higher compared to before surgery.

Conclusions: The results in this study indicated that ADVANCE MP TKA changed patellofemoral joint kinematics compared to before surgery. Early postoperative evaluation is the limitation of this study; however, we consider that the results in this study might be one of the keys to resolving the kinematic features of this prosthesis, helping clinicians to comprehend this prosthesis.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / instrumentation*
  • Arthroplasty, Replacement, Knee / methods
  • Biomechanical Phenomena
  • Humans
  • Knee Prosthesis*
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery
  • Patellofemoral Joint / physiopathology
  • Patellofemoral Joint / surgery*
  • Postoperative Complications
  • Preoperative Period
  • Prosthesis Design*
  • Range of Motion, Articular
  • Treatment Outcome
  • Weight-Bearing