Évaluation clinique et biomécanique de deux différents types d’arthroplastie totale de genou
Various implants of total knee arthroplasty (TKA) are used in clinical practice and each presents specific biomechanical characteristics. No implant managed this day to reproduce perfectly the biomechanics of the natural knee. The objectives of this study are to compare the clinical and tridimensional (3D) biomechanical data of two different designs of TKA on the same patients and to compare the resulting 3D biomechanical data with those of asymptomatic knees. A cohort of fifteen patients with a traditional implant in one knee and an implant of new generation allowing a pivot in the contralateral knee was studied. The control group was composed of thirty-five asymptomatic knees. Assessment of 3D knee kinematics analysis was realized with the KneeKG (Emovi Inc. Canada) during treadmill gait. Clinical evaluation included range of motion as well as questionnaires of joint perception, KOOS, Womac and SF-12. Results showed some statistically significant differences in knee 3D kinematics of both TKAs in sagittal and frontal planes while comparison between TKAs and asymptomatic knees revealed several significant differences in all three planes. Clinical scores of both TKAs did not have significant difference. In our cohort of patients, TKA implant design had few measurable influences on kinematics during gait and on clinical results. TKA with these implants did not reproduce natural knee kinematics during gait. Significant research and development in new TKA designs are needed to improve clinical scores and reproduce natural knee kinematics.
KneeKG Total knee arthroplasty Kinematics KneeKG Gait analysis Biomechanics