Moderate External Rotation of Tibial Component Generates More Natural Kinematics Than Internal Rotation After Total Knee Arthroplasty

Chaohua Fang; Yichao Luan; Zhiwei Wang; Long Shao; Tiebing Qu; Cheng-Kung Cheng

doi:10.3389/fbioe.2022.910311

Moderate External Rotation of Tibial Component Generates More Natural Kinematics Than Internal Rotation After Total Knee Arthroplasty

Front Bioeng Biotechnol. 2022 Jul 13:10:910311. doi: 10.3389/fbioe.2022.910311. eCollection 2022.

Authors

Chaohua Fang^{1

2

3}, Yichao Luan⁴, Zhiwei Wang⁵, Long Shao¹, Tiebing Qu^{6

7}, Cheng-Kung Cheng^{2

3}

Affiliations

¹ Department of Joint Surgery, Ningbo No. 6 Hospital, Ningbo, China.
² School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
³ Engineering Research Center of Digital Medicine, Ministry of Education, Shanghai, China.
⁴ School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
⁵ Department of Orthopaedics, Beijing Chaoyang Hospital, Beijing, China.
⁶ Department of Orthopaedics, Beijing Boai Hospital, Beijing, China.
⁷ The Center of Diagnosis and Treatment for Joint Disease, China Rehabilitation Research Center, Beijing, China.

Abstract

This study aimed to investigate the influence of tibial malrotation on knee kinematics after total knee arthroplasty (TKA). A symmetric fixed-bearing posterior-stabilized prosthesis was implanted in the validated knee model with different rotational alignments of the tibial component (neutral, 3° external rotation, 5° external rotation, 3° internal rotation, and 5° internal rotation). Computational kinematic simulations were used to evaluate the postoperative kinematics of the knee joint including anteroposterior translation femoral condyles and axial rotation of tibial component during 0°-135° knee flexion. The results revealed that the neutral position of the tibial component was not the closest kinematics to the intact knee, the model with 5° external rotation of the tibial component showed the closest lateral condyle translation and tibial axial rotation, and moderate external rotation could improve the kinematics after TKA.

Keywords: computational simulation; kinematics; rotational alignment; tibial component; total knee arthroplasty.