Total knee replacements: component design, pain prevention and research techniques

Abstract

Total knee arthroplasty is a surgical procedure m which the knee is resurfaced with implants to relieve pam. This thesis presents computed tomography and radiography methods to determine the relative position (kinematics) for the patellofemoral and tibiofemoral joints zn vivo for a full range of motion, as well as parameters related to surgical technique. These methods were used to compare: (1) subjects with gender-specific (GS) versus traditional implant designs, (2) symptomatic versus asymptomatic subjects, and (3) static versus dynamic kinematics. Quality of life (QOL) was also measured. GS implants only had a small but significant difference in patellofemoral translation in early flexion; no other differences were found for the kinematics or QOL. For all symptomatic subjects, differences in kinematics or surgical parameters were found, suggesting the cause for the subject's postoperative pain. Static and dynamic kinematics were comparable in all but one case, where internal/external tibial rotation differed.