Aim To compare a medial pivot (MP) total knee arthroplasty (TKA) with posterior stabilized (PS) TKA designs from a subjective, clinical and biomechanical point of view, in a single-centre, single-surgeon, case-control non-randomized trial. Methods Sixteen patients were randomly picked up from case series into each group. Subjective outcome was assessed using the Forgotten Joint Score Questionnaire (FJSQ). Clinical evaluation included range of motion (ROM). All patients underwent gait analysis by a treadmill with force-measuring plaques and videorecording device; data were recorded for 30 seconds and included cadence, step length, stance time and walking speed. A blinded qualitative analysis of the pattern of gait was defined as biphasic or non-biphasic. Descriptive statistics for the continuous study variables and statistical significance were calculated for all parameters with independent-samples t-test and χ2 test to analyse difference in pattern of gait between groups. Results Mean FJSQ in the MP group was 91.87 (CI 95%: 88.12- 95.46) and 75.31 (CI 95%: 67.97-81.56) in the PS group (p=0.029). Mean post-operative ROM was 117° (CI 95%: 113°-122°) in the MP group and 112° (CI 95%: 108°-117°) in the PS group (p=0.14). No statistical difference was found between groups regarding all gait analysis parameters which have been recorded. Conclusion MP TKA design showed better subjective results using the FJSQ, but it did not improve significantly clinical and functional outcomes compared to PS TKA design, at a short-term follow-up.
Bourne R, Chesworth B, Davis A, Mahomed N, Charron K. Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not? Clin Orthop Relat Res. 2010. p. 57–63.
2.
Hamilton D, Howie C, Burnett R, Simpson A, Patton J. Dealing with the predicted increase in demand for revision total knee arthroplasty: Challenges, risks and opportunities. Bone Jt J. 2015. p. 723–8.
3.
Vaillant T, Steelandt J, Cordonnier A, Haghighat S, Anract P, Paubel P, et al. Review of patientspecific instrumentation for total knee prosthesis. Ann Pharm Fr. 2018. p. 228–34.
4.
Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007. p. 780–5.
5.
Tolk J, Van Der Steen M, Janssen R, Reijman M. Total knee arthroplasty: what to expect? A survey of the members of the Dutch Knee Society on long-term recovery after total knee arthroplasty. J Knee Surg. 2017. p. 612–6.
6.
Noble P, Gordon M, Weiss J, Reddix R, Conditt M, Mathis K. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005. p. 157–65.
7.
Vaishya R, Agarwal A, Vijay V. Extensor mechanism disruption after total knee arthroplasty: a case series and review of literature. Cureus. 2016. p. 479.
8.
Komistek R, Dennis D, Mahfouz M. In vivo fluoroscopic analysis of the normal human knee. Clin Orthop Relat Res. 2003. p. 69–81.
9.
Vince K. Mid-flexion instability after total knee arthroplasty: woolly thinking or a real concern. Bone Joint J. 2016. p. 84–8.
10.
Schmidt R, Komistek R, Blaha J, Penenberg B, Maloney W. Fluoroscopic analyses of cruciate-retaining and medial pivot knee implants. Clin Orthop Relat Res. 2003. p. 139–47.
11.
Dennis D, Komistek R, Mahfouz M, Haas B, Stiehl J. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 2003. p. 37–57.
12.
Blaha J, Mancinelli C, Simons W, Kish V, Thyagarajan G. Kinematics of the human knee using an open chain cadaver model. Clin Orthop Relat Res. 2003. p. 25–34.
13.
Freeman M, Pinskerova V. The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res. 2003. p. 35–43.
14.
Pinskerova V, Johal P, Nakagawa S, Sosna A, Williams A, Gedroyc W, et al. Does the femur roll-back with flexion? J Bone Joint Surg Br. 2004. p. 925–31.
15.
Van Duren B, Pandit H, Beard D, Zavatsky A, Gallagher J, Thomas N, et al. How effective are added constraints in improving TKR kinematics? J Biomech. 2007. p. 31–7.
16.
Freeman M, Pinskerova V. The movement of the normal tibio-femoral joint. J Biomech. 2005. p. 197–208.
17.
Mannan K, Scott G. The Medial Rotation total knee replacement: A clinical and radiological review at a mean followup of six years. J Bone Jt Surg -Ser B. 2009. p. 750–6.
18.
Fitch D, Sedacki K, Yang Y. Mid-to long-term outcomes of a medial-pivot system for primary total knee replacement: a systematic review and metaanalysis. Bone Joint Res. 2014. p. 297–304.
19.
Brinkman J, Bubra P, Walker P, Walsh W, Bruce W. Midterm results using a medial pivot total knee replacement compared with the Australian National Joint Replacement Registry data. ANZ J Surg. 2014. p. 172–6.
20.
Macheras G, Galanakos S, Lepetsos P, Anastasopoulos P, Papadakis S. A long term clinical outcome of the Medial Pivot Knee Arthroplasty System. Knee. 2017. p. 447–53.
21.
Karachalios T, Roidis N, Giotikas D, Bargiotas K, Varitimidis S, Malizos K. A mid-term clinical outcome study of the Advance Medial Pivot knee arthroplasty. Knee. 2009. p. 484–8.
22.
Amin A, Al-Taiar A, Sanghrajka A, Kang N, Scott G. The early radiological follow-up of a medial rotational design of total knee arthroplasty. Knee. 2008. p. 222–6.
23.
Sabatini L, Risitano S, Parisi G, Tosto F, Indelli P, Atzori F, et al. Medial pivot in total knee arthroplasty: literature review and our first experience. Clin Med Insights Arthritis Musculoskelet Disord. 2018. p. 1–4.
24.
Hossain F, Patel S, Rhee SJ, Haddad F. Knee arthroplasty with a medially conforming ball-and-socket tibiofemoral articulation provides better function. Clin Orthop Relat Res. 2011. p. 55–63.
25.
Samy D, Wolfstadt J, Vaidee I, Backstein D. A retrospective comparison of a medial pivot and posterior-stabilized total knee arthroplasty with respect to patient-reported and radiographic outcomes. J Arthroplasty. 2018. p. 1379–83.
26.
Benjamin B, Pietrzak J, Tahmassebi J, Haddad F. A functional comparison of medial pivot and condylar knee designs based on patient outcomes and parameters of gait. Bone Joint J. 2018. p. 76–82.
27.
Behrend H, Giesinger K, Giesinger J, Kuster M. The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty. 2012. p. 430–6.
28.
Moonot P, Mu S, Railton G, Field R, Banks S. Tibiofemoral kinematic analysis of knee flexion for a medial pivot knee. Knee Surg Sports Traumatol Arthrosc. 2009. p. 927–34.
29.
Varadarajan K, Zumbrunn T, Rubash H, Malchau H, Li G, Muratoglu O. Cruciate retaining implant with biomimetic articular surface to reproduce activity dependent kinematics of the normal knee. J Arthroplasty. 2015. p. 2149–53.
30.
Blaha J. The rationale for a total knee implant that confers anteroposterior stability throughout range of motion. J Arthroplasty. 2004. p. 22–6.
31.
Wang H, Simpson K, Chamnongkich S, Kinsey T, Mahoney O. A biomechanical comparison between the single-axis and multi-axis total knee arthroplasty systems for the stand-to-sit movement. Clin Biomech. 2005. p. 428–33.
32.
Barnes C, Lincoln D, Wilson B, Bushmaier M. Knee manipulation after total knee arthroplasty: comparison of two implant designs. J Surg Orthop Adv. 2013. p. 157–9.
33.
Chinzei N, Ishida K, Tsumura N, Matsumoto T, Kitagawa A, Iguchi T, et al. Satisfactory results at 8 years mean follow-up after ADVANCE® medial-pivot total knee arthroplasty. Knee. 2014. p. 387–90.
34.
Bordini B, Ancarani C, Fitch D. Long-term survivorship of a medial-pivot total knee system compared with other cemented designs in an arthroplasty registry. J Orthop Surg Res. 2016. p. 44.
35.
Fan C, Hsieh J, Hsieh M, Shih Y, Lee C. Primitive results after medial-pivot knee arthroplasties. A minimum 5-year follow-up study. J Arthroplasty. 2010. p. 492–6.
36.
Shakespeare D, Ledger M, Kinzel V. Flexion after total knee replacement. A comparison between the Medial Pivot knee and a posterior stabilised implant. Knee. 2006. p. 371–3.
37.
Bae D, Cho S Do, Im S, Song S. Comparison of midterm clinical and radiographic results between total knee arthroplasties using medial pivot and posterior-stabilized prosthesis-a matched pair analysis. J Arthroplasty. 2016. p. 419–24.
38.
Kim Y, Yoon S, Kim J. Early outcome of TKA with a medial pivot fixed-bearing prosthesis is worse than with a PFC mobile-bearing prosthesis. Clin Orthop Relat Res. 2009. p. 493–503.
39.
Thienpont E, Opsomer G, Koninckx A, Houssiau F. Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint score. J Arthroplasty. 2014. p. 48–51.
40.
Matsumoto M, Baba T, Homma Y, Kobayashi H, Ochi H, Yuasa T, et al. Validation study of the Forgotten Joint Score-12 as a universal patient-reported outcome measure. Eur J Orthop Surg Traumatol. 2015. p. 1141–5.
41.
Hamilton D, Loth F, Giesinger J, Giesinger K, Macdonald D, Patton J, et al. Validation of the English language Forgotten Joint Score-12 as an outcome measure for total hip and knee arthroplasty in a British population. Bone Joint J. 2017. p. 218–24.
42.
Thomsen M, Latifi R, Kallemose T, Barfod K, Husted H, Troelsen A. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty. Acta Orthop. 2016. p. 280–5.
43.
Schotanus M, Pilot P, Vos R, Kort N. No difference in joint awareness after mobile-and fixed-bearing total knee arthroplasty: 3-year follow-up of a randomized controlled trial. Eur J Orthop Surg Traumatol. 2017. p. 1151–5.
44.
Bellamy N, Buchanan W, Goldsmith C, Campbell J, Stitt L. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988. p. 1833–40.
45.
Weinberger M, Samsa G, Hanlon J, Schmader K, Doyle M, Cowper P, et al. An evaluation of a brief health status measure in elderly veterans. J Am Geriatr Soc. 1991. p. 691–4.
46.
Insall J, Dorr L, Scott R, Scott W. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989. p. 13–4.
47.
Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998. p. 63–9.
48.
Kettelkamp D, Johnson R, Smidt G, Chao E, Walker M. An electrogoniometric study of knee motion in normal gait. J Bone Joint Surg Am. 1970. p. 775–90.
49.
Martin J, Whiteside L. The influence of joint line position on knee stability after condylar knee arthroplasty. Clin Orthop Relat Res. 1990. p. 146–56.
50.
Cross M, Nam D, Plaskos C, Sherman S, Lyman S, Pearle A, et al. Recutting the distal femur to increase maximal knee extension during TKA causes coronal plane laxity in mid-flexion. Knee. 2012. p. 875–9.
51.
Clavé A, Henaff L, Roger G, Maisongrosse T, Mabit P, Dubrana C, et al. Joint line level in revision total knee replacement: assessment and functional results with an average of seven years follow-up. Int Orthop. 2016. p. 1655–62.
52.
Ramappa M. Midflexion instability in primary total knee replacement : a review. SICOT J. 2015. p. 24.
53.
Chiu MC, Wang MJ. The effect of gait speed and gender on perceived exertion, muscle activity, joint motion of lower extremity, ground reaction force and heart rate during normal walking. Gait Posture. 2007. p. 385–92.
54.
Riley P, Dellacroce U, Kerrigan D. Effect of age on lower extremity joint moment contributions to gait speed. Gait Posture. 2001. p. 264–70.
55.
Stan G, Orban H. Human gait and postural control after unilateral total knee arthroplasty. Maedica (Buchar). 2014. p. 356–60.
56.
Wilson S, Mccann P, Gotlin R, Ramakrishnan H, Wootten M, Insall J. Comprehensive gait analysis in posterior-stabilized knee arthroplasty. J Arthroplasty. 1996. p. 359–67.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
