Cementless unicondylar knee implants are intended to offer surgeons the potential of a faster and less invasive surgery experience in comparison to cemented procedures. However, initial 8 week fixation with micromotion less than 150µm is crucial to their survivorship1 to avoid loosening2. Test methods by Davignon et al3 for micromotion were used to assess fixation of the MAKO UKR Tritanium (MAKO) (Stryker, NJ) and the Oxford Cementless UKR (Biomet, IN). Data was analyzed to determine the activities of daily living (ADL) that generate the highest forces and displacements4, 5. Stair ascent with 3.2BW compressive posterior tibial load was identified to be an ADL which may cause the most micromotion5. Based on previous studies6, 10,000 cycles was set as the run-time. The AP and IE profiles were scaled back to 60% for the Oxford samples to prevent the congruent insert from dislocating. A four-axis test machine (MTS, MN) was used. The largest size UKRs were prepared per manufacturer's surgical technique. Baseplates were inserted into Sawbones (Pacific Research, WA) blocks1. Femoral components were cemented to arbors. The medial compartment was tested, and the lateral implants were attached to balance the loads. Five tests were conducted for each implant with a new Sawbones and insert for each test per the test method3. The ARAMIS System (GOM, Germany) was used to measure relative motion between the baseplate and the Sawbones at three anteromedial locations (Fig. 1). Peak-Peak (P-P) micromotion was calculated in the compressive and A/P directions. FEA studies replicating the most extreme static loading positions for MAKO micromotion were conducted to compare with the physical test results using ANSYS14.5 (ANSYS, PA).Introduction
Methods
The MAKO Surgical Rio Robotic Arm utilizes the pre-op CT images to plan positioning of the uni-condylar and patella-femoral components in order to achieve the most desirable kinematics for the knee joint. We hypothesize that the anatomic matching surfaces and the cruciate retaining design of the Restoris knee will best replicate normal knee kinematics. We tested the healthy cadaveric knee versus the MAKO knee and the most common TKR designs in order to evaluate and compare the kinematic properties. Six healthy male left knees were dissected to leave only the knee capsule and the quadriceps tendon intact. The femur and the tibia were cut 20cm from the joint line and potted with cement into a metal housing. The knee was attached to a crouching machine capable of moving the knee joint though its normal human kinematics from extension to maximum flexion, validated in previous studies. Forces applied to the quadriceps tendon allowed the knee to flex and extend physiologically, and springs attached to the posterior were substituted as the hamstrings at a rate of half the force exerted by the quadriceps as shown in the literature. Three dimensional visual targets attached to the bones were tracked by computer software capable of recreating the positions of the bones in any given flexion angle. A cruciate retaining and posterior stabilized TKR design were chosen to represent the TKRs most commonly available in the market today. The intact knee, MAKO implanted knee, CR and PS TKR designs were tested in sequence on the same specimens. The computer software analyzed the normal distance between the bone surfaces and plotted the locations of contact which could then be quantitatively compared for each given scenario [Fig. 1].Introduction
Methods
