Dataset Information

No differences in knee kinematics between active and passive flexion-extension movement: an intra-operative kinematic analysis performed during total knee arthroplasty.

ABSTRACT: PURPOSE:The objective of the present study was to acquire and compare by the use of a navigation system the intra-operative flexion-extension movement of the knee performed actively by the patient and passively by the surgeon before and after a total knee arthroplasty (TKA) implantation. METHODS:A cohort of 31 patients with primary knee osteoarthritis (OA), candidate for TKA underwent intra-operative kinematics assessment with a commercial navigation system before and after the definitive implant positioning of a Cruciate Retaining (CR) Mobile Bearing (MB) prostheses. The kinematical data were acquired while surgeon performed the flexion-extension movement (passive ROM - pROM), and while the patient performed it (active ROM - aROM). Differences between pre- and post- implantation and between active and passive motions, were statistically analyzed using paired Student t-tests (p?=?0.05). RESULTS:No statistically significant difference were found between aROM and pROM with paired Student t-test regarding internal-external rotation and anterior-posterior translation of the femoral component with respect to the tibia during flexion-extension movement before and after TKA implant (p?>?0.05). CONCLUSIONS:Active muscle contraction seems to not significantly affect TKA kinematics. The ROM performed by the surgeon during operation resemble the movement actively performed by the patient. The clinical relevance of this study further supports the use of CAS system in performing intra-operative analysis concerning knee biomechanics.

SUBMITTER: Grassi A

PROVIDER: S-EPMC7067969 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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No differences in knee kinematics between active and passive flexion-extension movement: an intra-operative kinematic analysis performed during total knee arthroplasty.

Grassi Alberto A Pizza Nicola N Lopomo Nicola Francesco NF Marcacci Maurilio M Capozzi Michele M Marcheggiani Muccioli Giulio Maria GM Colle Francesca F Zaffagnini Stefano S

Journal of experimental orthopaedics 20200312 1

<h4>Purpose</h4>The objective of the present study was to acquire and compare by the use of a navigation system the intra-operative flexion-extension movement of the knee performed actively by the patient and passively by the surgeon before and after a total knee arthroplasty (TKA) implantation.<h4>Methods</h4>A cohort of 31 patients with primary knee osteoarthritis (OA), candidate for TKA underwent intra-operative kinematics assessment with a commercial navigation system before and after the de ...[more]

PMID: 32166475

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Project description:A precise and comprehensive definition of "normal" in vivo cervical kinematics does not exist due to high intersubject variability and the absence of midrange kinematic data. In vitro test protocols and finite element models that are validated using only end range of motion data may not accurately reproduce continuous in vivo motion.The primary objective of this study was to precisely quantify cervical spine intervertebral kinematics during continuous, functional flexion-extension in asymptomatic subjects. The advantages of assessing continuous intervertebral kinematics were demonstrated by comparing asymptomatic controls with patients with single-level anterior arthrodesis.Cervical spine kinematics were determined during continuous in vivo flexion-extension in a clinically relevant age group of asymptomatic controls and a group of patients with C5-C6 arthrodesis.The patient sample consisted of 6 patients with single-level (C5-C6) anterior arthrodesis (average age: 48.8±6.9 years; 1 male, 5 female; 7.6±1.2 months postsurgery) and 18 asymptomatic control subjects of similar age (average age: 45.6±5.8 years; 5 male, 13 female).Outcome measures included the physiologic measure of continuous kinematic motion paths at each cervical motion segment (C2-C7) during flexion-extension.Participants performed flexion-extension while biplane radiographs were collected at 30 images per second. A previously validated tracking process determined three-dimensional vertebral positions with submillimeter accuracy. Continuous flexion-extension rotation and anterior-posterior translation motion paths were adjusted for disc height and static orientation of each corresponding motion segment.Intersubject variability in flexion-extension angle was decreased 15% to 46% and intersubject variability in anterior-posterior translation was reduced 14% to 33% after adjusting for disc height and static orientation angle. Average intersubject variability in continuous motion paths was 1.9° in flexion-extension and 0.6 mm in translation. Third-order polynomial equations were determined to precisely describe the continuous flexion-extension and anterior-posterior translation motion path at each motion segment (all R2>0.99).A significant portion of the intersubject variability in cervical kinematics can be explained by the disc height and the static orientation of each motion segment. Clinically relevant information may be gained by assessing intervertebral kinematics during continuous functional movement rather than at static, end range of motion positions. The fidelity of in vitro cervical spine mechanical testing protocols may be evaluated by comparing in vitro kinematics to the continuous motion paths presented.

Dataset Information

No differences in knee kinematics between active and passive flexion-extension movement: an intra-operative kinematic analysis performed during total knee arthroplasty.

Publications

No differences in knee kinematics between active and passive flexion-extension movement: an intra-operative kinematic analysis performed during total knee arthroplasty.

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