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• W3009892611 abstract "Abstract Background Unexplained pain in the medial proximal tibia frequently leads to revision after unicondylar knee arthroplasty (UKA). As one of the most important factors for osteogenic adaptive response, increased bone strain following UKA has been suggested as a possible cause. Questions/purposes In this study we: (1) performed a cadaver-based kinematic analysis on paired cadaveric specimens before and after mobile-bearing and fixed-bearing UKA; and (2) simultaneously characterized the strain distribution in the anterior and posterior proximal tibia during squatting. Methods Five pairs of fresh, frozen full-leg cadaver specimens (four male, one female, 64 years to 87 years) were subjected to a dynamic squatting motion on a kinematic rig to simulate joint loading for a large ROM. Forces were applied to the quadriceps and hamstrings during the simulation while an infrared camera system tracked the location of reflective markers attached to the tibia and femur. Tibial cortical bone strain was measured with stacked strain gauge rosettes attached at predefined anterior and posterior positions on the medial cortex. Pairwise implantation of mobile-bearing (UKA MB ) and fixed-bearing implants (UKA FB ) allowed a direct comparison of right and left knees from the same donor through a linear mixed model. Results UKA MB more closely replicated native kinematics in terms of tibial rotation and in AP and mediolateral translation. Maximum principal bone strain values were consistently increased compared with native (anteromedial, mean [± SD] peak strain: 311 µε ± 190 and posterior, mean peak strain: 321 µε ± 147) with both designs in the anteromedial (UKA FB , mean peak strain: 551 µε ± 381, Cohen’s d effect size 1.3 and UKA MB , mean peak strain: 596 µε ± 564, Cohen’s d effect size 1.5) and posterior (UKA FB , mean peak strain: 505 µε ± 511, Cohen’s d effect size 1.3 and UKA MB , mean peak strain: 633 µε ± 424, Cohen’s d effect size 2.1) region. However, in the anterolateral region of the medial tibial bone, UKA FB demonstrated the overall largest increase in strain (mean peak strain: 1010 µε ± 787, Cohen’s d effect size 1.9), while UKA MB (613 µε ± 395, Cohen’s d effect size 0.2) closely replicated values of the native knee (563 µε ± 234). Conclusion In this in vitro cadaver study both UKA MB and UKA FB led to an increase in bone strain in comparison with the native knee. However, in the anterolateral region of the medial tibial plateau, proximal tibial bone strain was lower after UKA MB and UKA FB . Both UKA MB and UKA FB lead to comparable increases in anteromedial and posterior tibial strain in comparison with the native knee. In the anterolateral region of the medial tibial plateau UKA, proximal tibial bone strain was closer to the native knee after UKA MB than after UKA FB . In an attempt to link kinematics and strain behavior of these designs there seemed to be no obvious relation. Clinical Relevance Further clinical research may be able to discern whether the observed differences in cortical strain after UKA is associated with unexplained pain in patients and whether the observed differences in cortical bone strain between mobile-bearing and fixed unicondylar designs results in a further difference in unexplained pain." @default.
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• W3009892611 date "2020-02-25" @default.
• W3009892611 modified "2023-10-16" @default.
• W3009892611 title "Does Unicondylar Knee Arthroplasty Affect Tibial Bone Strain? A Paired Cadaveric Comparison of Fixed- and Mobile-bearing Designs" @default.
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• W3009892611 doi "https://doi.org/10.1097/corr.0000000000001169" @default.
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