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Article
Robotic Testing of Proximal Tibio-Fibular Joint Kinematics for Measuring Instability Following Total Knee Arthroplasty
Journal of Orthopaedic Research
  • Wael K. Barsoum, Cleveland Clinic
  • Ho H. Lee, Cleveland Clinic
  • Trevor G. Murray, Cleveland Clinic
  • Robb Colbrunn, Cleveland Clinic
  • Alison K. Klika, Cleveland Clinic
  • S. Butler, Cleveland Clinic
  • Antonie J. van den Bogert, Cleveland State University
Document Type
Article
Publication Date
1-1-2011
Abstract
Pain secondary to instability in total knee arthroplasty (TKA) has been shown to be major cause of early failure. In this study, we focused on the effect of instability in TKA on the proximal tibio-fibular joint (PTFJ). We used a robotics model to compare the biomechanics of the PTFJ in the native knee, an appropriately balanced TKA, and an unbalanced TKA. The tibia (n = 5) was mounted to a six-degree-of-freedom force/torque sensor and the femur was moved by a robotic manipulator. Motion at the PTFJ was recorded with a high-resolution digital camera system. After establishing a neutral position, loading conditions were applied at varying flexion angles (0°, 30°, and 60°). These included: internal/external rotation (0 Nm, ±5 Nm), varus/valgus (0 Nm, ±10 Nm), compression (100 N, 700 N), and posterior drawer (0 N, 100 N). With respect to anterior displacement, external rotation had the largest effect (coefficient = 0.650; p < 0.0001). Polyethylene size as well as the interaction between polyethylene size and flexion consistently showed substantial anterior motion. Flexion and mid-flexion instability in TKA have been difficult to quantify. While tibio-femoral kinematics is the main aspect of TKA performance, the effects on adjacent tissues should not be overlooked. Our data show that PTFJ kinematics are affected by the balancing of the TKA. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:47–52, 2011
DOI
10.1002/jor.21207
Version
Postprint
Citation Information
Barsoum, W. K., Lee, H. H., Murray, T. G., Colbrunn, R., Klika, A. K., Butler, S., & van den Bogert, A. J. (2011). Robotic testing of proximal tibio-fibular joint kinematics for measuring instability following total knee arthroplasty. Journal of Orthopaedic Research, 29(1), 47-52. doi: 10.1002/jor.21207