Zambianchi Francesco, Fiacchi Francesco, Lombari Vincenzo, Venturelli Luca, Marcovigi Andrea, Giorgini Andrea, Catani Fabio
Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy.
Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy.
Clin Biomech (Bristol). 2018 May;54:92-102. doi: 10.1016/j.clinbiomech.2018.03.014. Epub 2018 Mar 20.
Journey II Bi-Cruciate-Stabilized knee system was designed to overcome the complications of Journey Bi-Cruciate-Stabilized, including ilio-tibial band inflammation and episodes of dislocation. The purpose of this study was to assess differences in knee kinematics between the first and second-generation design by means of video-fluoroscopy. Re-designed prosthesis in-vivo kinematics was analyzed during activities of daily living and results were eventually compared with those of the previous system, as reported in a previously published study. It was hypothesized that changes in components' design influences replaced knee's kinematic patterns.
Sixteen patients (3 males, 13 females) implanted with the redesigned prosthesis were assessed by video-fluoroscopy during stair-climbing, chair-rising and leg-extension at 8 months of follow-up. Patterns of axial rotation and antero-posterior motion of the medial and lateral femoral condyles were obtained. Range of Motion and International Knee Society Score were recorded pre- and post-operatively. Student t-tests were applied to compare the mean of each interesting variables.
The comparison of the kinematics of the two designs revealed similar patterns of axial rotation, with progressive femoral external rotation in flexion and reduced absolute values of displacement for the new system. Reduced posterior displacements of the medial and lateral condyles were observed in Journey II patients. In terms of absolute location, the lateral condyle in the redesigned prosthesis showed a more anterior position on the tibial-baseplate embedded coordinate system at maximal flexion.
Design changes in the recently-introduced total knee system contributed to modify its in-vivo knee kinematics as demonstrated by video-fluoroscopy.
Journey II双交叉韧带稳定型膝关节系统旨在克服Journey双交叉韧带稳定型膝关节系统的并发症，包括髂胫束炎症和脱位情况。本研究的目的是通过视频荧光透视法评估第一代和第二代设计之间膝关节运动学的差异。在日常生活活动期间分析重新设计的假体的体内运动学，并最终将结果与先前发表的研究中报道的先前系统的结果进行比较。假设组件设计的变化会影响置换膝关节的运动模式。
在随访8个月时，通过视频荧光透视法对16名植入重新设计假体的患者（3名男性，13名女性）进行爬楼梯、从椅子上起身和腿部伸展动作的评估。获得了股骨内侧髁和外侧髁的轴向旋转模式以及前后运动模式。记录术前和术后的活动范围和国际膝关节协会评分。应用学生t检验来比较每个感兴趣变量的平均值。
两种设计的运动学比较显示轴向旋转模式相似，屈曲时股骨逐渐向外旋转，新系统的位移绝对值减小。在Journey II患者中观察到内侧髁和外侧髁的后移减少。就绝对位置而言，在最大屈曲时，重新设计的假体中的外侧髁在胫骨基板嵌入式坐标系上显示出更靠前的位置。
如视频荧光透视法所示，最近推出的全膝关节系统的设计变化有助于改变其体内膝关节运动学。
