Kinematic Patterns of Different Loading Profiles Before and After Total Knee Arthroplasty: A Cadaveric Study

One of the major goals of total knee arthroplasty (TKA) is to restore the physiological function of the knee. In order to select the appropriate TKA design for a specific patient, it would be helpful to understand whether there is an association between passive knee kinematics intraoperatively and during complex activities, such as ascending stairs. Therefore, the primary objective of this study was to compare the anterior-posterior (AP) range of motion during simulated passive flexion and stair ascent at different conditions in the same knees using a six-degrees-of-freedom joint motion simulator, and secondary, to identify whether differences between TKA designs with and without a post-cam mechanism can be detected during both activities, and if one design is superior in recreating the AP translation of the native knee. It was shown that neither TKA design was superior in restoring the mean native AP translation, but that both CR/CS and PS TKA designs may be suitable to restore the individual native kinematic pattern. Moreover, it was shown that passive and complex loading scenarios do not result in exactly the same kinematic pattern, but lead to the same choice of implant design to restore the general kinematic behavior of the native individual knee.