Background: Total Knee Replacement surgery restores joint function in patients with advanced osteoarthritis. There are several prostheses available based on different mechanisms, which guarantee knee stability during Activities of Daily Living. The aim of this study is to compare ball-in-socket (or Medial Pivot) and post-cam mechanisms to detect possible differences in terms of biomechanical parameters between these two prosthesis designs and to evaluate which design is closer to physiological biomechanics. Methods: A kinematics, kinetics and electromyography lower limb analyses were performed during gait on sixty subjects: twenty with Medial Pivot prosthesis, twenty with posterior stabilized prosthesis and twenty healthy subjects to obtain a physiologic reference. Findings: Total Knee Replacement gait pattern for both patient groups were characterized by reduced walking speed, reduced stride length and increased stance time respect to control group. Comparison between Medial Pivot and Posterior Stabilized groups showed a reduction of knee flexion and flexor moment in patients with ball-in-socket mechanism. A prolonged muscular activity of rectus femoris was observed in Medial Pivot patients compared to Posterior Stabilized and control groups. Interpretation: “Stiff knee pattern” mechanism was showed for both patient groups but more enhanced in Medial Pivot patients. Even though the Posterior Stabilized design introduces the non-physiological paradoxical motion and the Medial Pivot design seems to better reproduce the physiological condylar movement as gait analysis parameters, including kinematics, kinetics and electromyographic parameters were closer to control group and, in turn, to physiological gait for the Posterior Stabilized than Medial Pivot group parameters.

Biomechanical analysis on total knee replacement patients during gait: Medial pivot or posterior stabilized design? / Esposito, Francesco; Freddolini, Marco; Marcucci, Massimiliano; Latella, Leonardo; Corvi, Andrea. - In: CLINICAL BIOMECHANICS. - ISSN 0268-0033. - STAMPA. - 78:(2020), pp. 105068-105074. [10.1016/j.clinbiomech.2020.105068]

Biomechanical analysis on total knee replacement patients during gait: Medial pivot or posterior stabilized design?

Esposito, Francesco;Marcucci, Massimiliano;Latella, Leonardo;Corvi, Andrea
2020

Abstract

Background: Total Knee Replacement surgery restores joint function in patients with advanced osteoarthritis. There are several prostheses available based on different mechanisms, which guarantee knee stability during Activities of Daily Living. The aim of this study is to compare ball-in-socket (or Medial Pivot) and post-cam mechanisms to detect possible differences in terms of biomechanical parameters between these two prosthesis designs and to evaluate which design is closer to physiological biomechanics. Methods: A kinematics, kinetics and electromyography lower limb analyses were performed during gait on sixty subjects: twenty with Medial Pivot prosthesis, twenty with posterior stabilized prosthesis and twenty healthy subjects to obtain a physiologic reference. Findings: Total Knee Replacement gait pattern for both patient groups were characterized by reduced walking speed, reduced stride length and increased stance time respect to control group. Comparison between Medial Pivot and Posterior Stabilized groups showed a reduction of knee flexion and flexor moment in patients with ball-in-socket mechanism. A prolonged muscular activity of rectus femoris was observed in Medial Pivot patients compared to Posterior Stabilized and control groups. Interpretation: “Stiff knee pattern” mechanism was showed for both patient groups but more enhanced in Medial Pivot patients. Even though the Posterior Stabilized design introduces the non-physiological paradoxical motion and the Medial Pivot design seems to better reproduce the physiological condylar movement as gait analysis parameters, including kinematics, kinetics and electromyographic parameters were closer to control group and, in turn, to physiological gait for the Posterior Stabilized than Medial Pivot group parameters.
2020
78
105068
105074
Goal 3: Good health and well-being for people
Esposito, Francesco; Freddolini, Marco; Marcucci, Massimiliano; Latella, Leonardo; Corvi, Andrea
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0268003320301868-main.pdf

Accesso chiuso

Tipologia: Pdf editoriale (Version of record)
Licenza: DRM non definito
Dimensione 413.6 kB
Formato Adobe PDF
413.6 kB Adobe PDF   Richiedi una copia

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1197235
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 7
social impact