Biomechanical alterations in total knee arthroplasty / 中国组织工程研究

ABSTRACT

This paper analyzed the effects of prosthesis selection and surgical technique in total knee arthroplasty (TKA) on patellofemoral joint biomechanics, patella movement track and prosthesis rotational alignment to explore the mechanics-related factors of knee joint function and prosthesis service life after TKA. Traditional anatomic landmark line lacks of accuracy due to various factors, so there is no uniform linear localization for tibial prosthesis. Femoral epicondylar axis functions as the reference axis of prosthesis rotational alignment in TKA, which can achieve ideal patellofemoral joint biomechanics, and reduce postoperative complications. 1/3 line of medial border to moderate medial border of the tibial tubercle is regarded as the ideal rotational interval o the tibial prosthesis, and introversion and extroversion degrees of the knee joint are determinant of linear localization. Knee symptoms and function are significantly improved after fixed and mobile-bearing arthroplasties. These two kinds of prosthesis do no significantly vary in knee joint, pain, function, and patella scores as well as radiography. However, the knee motions during maximum flexion in the mobile-bearing arthroplasty are smaller than in the fixed one. It has been proven by experimental studie that mobile-bearing arthroplasty shows wearing resistance and joint movement superior over the fixed one, but there is no agreemen in clinical studies.