Quadriceps force in relation of intrinsic anteroposterior stability of TKA design

Purpose Decreased quadriceps strength and fatigue is suspected to be one of the contributing factors for anterior knee pain and malfunction after total knee arthroplasty (TKA). The purpose of this in vitro study was to investigate the amount of quadriceps force required to extend the knee isokinetic...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2010-01, Vol.130 (1), p.1-9
Main Authors: Heyse, Thomas Jan, Becher, Christoph, Kron, Nadine, Ostermeier, Sven, Hurschler, Christof, Schofer, Markus D., Fuchs-Winkelmann, Susanne, Tibesku, Carsten O.
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Knee
Biomechanical Phenomena
Cadaver
Female
Humans
Knee
Knee Joint - physiology
Male
Medicine
Medicine & Public Health
Muscle Fatigue - physiology
Orthopaedic Surgery
Orthopedics
Quadriceps Muscle - physiology
Transplants & implants
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Summary:Purpose Decreased quadriceps strength and fatigue is suspected to be one of the contributing factors for anterior knee pain and malfunction after total knee arthroplasty (TKA). The purpose of this in vitro study was to investigate the amount of quadriceps force required to extend the knee isokinetically after TKA in dependence of different prosthesis designs and the state of the posterior cruciate ligament (PCL). Materials and methods Eight fresh frozen human knee specimens underwent testing in a kinematic device simulating an isokinetic knee extension cycle from 120° of flexion to full extension. The quadriceps force was measured after implantation of a cruciate retaining (CR) TKA (Genesis II, Smith&Nephew, Memphis, TN, USA) applying a conventional CR (11 mm) and a highly conforming (deep dished, DD) polyethylene (PE) inlay consecutively before and after resection of the PCL. Finally, tests were repeated with a posterior-stabilized (PS) design. Results Simulating a physiological knee extension, no significant differences in the average quadriceps force were detected between the cruciate preserving inlays (CR 1,146.57 ± 88.04 N, DD 1,150.19 ± 97.54 N, P  = 0.86) as long as the PCL was intact. After resection of the PCL, the required quadriceps force increased significantly for both designs (CR 1,203.17 ± 91.51 N, P  
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-009-0927-4