Abstract
Past work in our laboratory identified the generalized effects of TKA on muscle balance, showing a significant change in relative moment generating potential balance favoring flexion and external rotation relative to the normal (intact) knee (for both PCL sparing and posterior stabilized TKA). However, there are no reliable data descriptive of the effect of any single prosthesis. This study hypothesized that using a modern TKA (Smith Nephew Journey) and implantation by a single surgeon in five fresh cadaver specimens would result in change in muscle balance similar to the earlier results for posterior stabilized TKA.
Using the tendon excursion-angular motion method (MA = dr/dΘ, r is excursion, Θ is joint angle in radians), moment arms of all muscles at the knee were determined for each of three conditions (intact, ACL-deficient, and prosthesis). The moment arms were then multiplied by the known muscle tension fractions to generate each muscle’s relative moment potential for each specimen across the three conditions. The resultant summed total moment potential was then examined for differences in the flexion-extension (FE) and internal-external (IE) rotation components.
There was no significant difference in either FE or IE component for intact versus either the ACL deficient condition (FE, p=0.62, IE, p=0.49) or arthroplasty (FE, p=0.99, IE, p=0.82). TKA agreed more closely with the intact knee. Thus, we reject the hypothesis that a modern TKA (Journey) performs as projected by past generic results, and conclude that modern TKA effectively reconstructs the balance of the intact knee.
This improves prospects for rehabilitation following TKA.
Correspondence should be addressed to Diane Przepiorski at ISTA, PO Box 6564, Auburn, CA 95604, USA. Phone: +1 916-454-9884; Fax: +1 916-454-9882; E-mail: ista@pacbell.net
