Implant design affects walking and stair navigation after total knee arthroplasty: a double-blinded randomised controlled trial

• Published in: Journal of orthopaedic surgery and research Vol. 16; no. 1; p. 177
• Main Authors: Komaris, Dimitrios-Sokratis, Govind, Cheral, Murphy, Andrew James, Clarke, Jon, Ewen, Alistair, Leonard, Hollie, Riches, Philip
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.03.2021; BioMed Central; BMC
• Subjects: Activities of daily living; Age; Aged; Analysis; Arthroplasty (knee); Arthroplasty, Replacement, Knee - methods; Bearings; Biomechanical Phenomena; Biomechanics; Body mass index; Calibration; Clinical trials; Double-Blind Method; Female; Fixed bearing; Gait; Humans; Implant congruency; Implants, Artificial; Joint replacement surgery; Joint surgery; Kinetics; Knee; Knee Prosthesis; Male; Medical research; Medicine, Experimental; Middle Aged; Mobile bearing; Motion analysis; Motion capture; Orthopedics; Osteoarthritis; Patient satisfaction; Patients; Polyethylene; Prostheses; Prosthesis; Prosthesis Design; Range of motion; Stair Climbing - physiology; Statistical analysis; Surgery; Transplants & implants; Walking; Walking - physiology; Germany; Implant congruency; Range of motion; Fixed bearing; Mobile bearing; Motion analysis; Knee prosthesis
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-021-02311-x

Dissimilar total knee arthroplasty implant designs offer different functional characteristics. This is the first work in the literature to fully assess the Columbus ultra-congruent mobile (UCR) system with a rotating platform. This is a double-blinded randomised controlled trial, comparing the functional performance of the low congruent fixed (CR DD), ultra-congruent fixed (UC) and UCR Columbus Total Knee Systems. The pre-operative and post-operative functional performance of twenty-four osteoarthritic patients was evaluated against nine control participants when carrying out everyday tasks. Spatiotemporal, kinematic and kinetic gait parameters in walking and stair navigation were extracted by means of motion capture. The UC implant provided better post-operative function, closely followed by the UCR design. However, both the UC and UCR groups exhibited restricted post-operative sagittal RoM (walking, 52.1 ± 4.4° and 53.2 ± 6.6°, respectively), whilst patients receiving a UCR implant did not show an improvement in their tibiofemoral axial rotation despite the bearing's mobile design (walking, CR DD 13.2 ± 4.6°, UC 15.3 ± 6.7°, UCR 13.5 ± 5.4°). Patients with a CR DD fixed bearing showed a statistically significant post-operative improvement in their sagittal RoM when walking (56.8 ± 4.6°). It was concluded that both ultra-congruent designs in this study, the UC and UCR bearings, showed comparable functional performance and improvement after TKA surgery. The CR DD group showed the most prominent improvement in the sagittal RoM during walking. The study is registered under the clinical trial registration number: NCT02422251 . Registered on April 21, 2015.