SpringerLink
Log in

Biomechanics of Cruciate Retaining and Posterior Stabilised Total Knee Arthroplasty and Return to Sports

  • Chapter
  • First Online:
Orthopaedic Biomechanics in Sports Medicine

  • 1796 Accesses

Abstract

The anatomy of the knee is widely variable as are the pathological changes it undergoes in disease processes such as osteoarthritis. It is an inherently unstable joint relying heavily upon the surrounding soft tissues resulting in complex kinematics. The femoral roll-back and screw home mechanisms of knee movement during motion must be replicated within the design of a total knee prosthesis and within the surgery itself by balancing the soft tissues and aligning the knee appropriately in order to improve functional outcomes.

The average age of patients undergoing total knee arthroplasty is reducing, resulting in a more active patient with higher demands and expectations of their prosthesis. Many wish to return to some form of sport following their surgery. Whilst most surgeons recommend low impact, low demand and low duration sports, the evidence for this is lacking based primarily on opinion. In our review of the evidence, return to sports is variable depending upon the type of sport and how long the patient has been involved in this sport. Recommendations on return to sports following a total knee arthroplasty must be considered on a case-by-case basis with a full understanding of the patient’s expectations, pre-operative activity level and sporting experience.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Hartford JM. Sports after arthroplasty of the knee. Sports Med Arthrosc. 2003;11:149–54.

    Article  Google Scholar 

  2. Dagneaux L, Degeorge B. Return to sport after total or unicompartmental knee arthroplasty: an informative guide for residents to patients. EFORT Open Rev. 2017;2(December):496–501.

    Article  Google Scholar 

  3. Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ. Patient-reported activity level after total knee arthroplasty. J Arthroplasty. 2008;23(3):401–7.

    Article  Google Scholar 

  4. Healy WL, R Iorio, M J Lemos. Athletic activity after joint replacement. Am J Sports Med. 2001;29(3): 377–88.

    Google Scholar 

  5. McClelland JA, Webster KE, Feller JA. Gait analysis of patients following total knee replacement: a systematic review. Knee. 2007;14:253–63.

    Article  Google Scholar 

  6. Bradbury N, Borton D, Spoo G, Cross MJ. Participation in sports after total knee replacement. Am J Sports Med. 1998;26(4):530–5.

    Article  CAS  Google Scholar 

  7. Brittain R, Young E, Mccormack V, Swanson M. 16th Annual report. 16th Annual report 2019 National Joint Registry England, Wales, North Ireland and Isle of Man, December 2018; 2019.

    Google Scholar 

  8. Shenoy R, Pastides PS, Nathwani D. Biomechanics of the knee and TKR. Orthop Trauma. 2013;27(6):364–71. https://doi.org/10.1016/j.mporth.2013.10.003.

    Article  Google Scholar 

  9. Collins M, Lavigne M, Girard J, Vendittoli P. Joint perception after hip or knee replacement surgery. Orthop Traumatol Surg Res. 2012;98(3):275–80. https://doi.org/10.1016/j.otsr.2011.08.021.

    Article  CAS  PubMed  Google Scholar 

  10. Witjes S, Gouttebarge V, Kuijer PPFM, Van Geenen RCI, Poolman RW, Kerkhoffs GMMJ. Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and meta-analysis. Sports Med. 2016;46(2):269–92.

    Article  Google Scholar 

  11. Fitzpatrick CK, Clary CW, Rullkoetter PJ. The role of patient, surgical, and implant design variation in total knee replacement performance. J Biomech. 2012;45(12):2092–102. https://doi.org/10.1016/j.jbiomech.2012.05.035.

    Article  PubMed  Google Scholar 

  12. Flecher X, Argenson JN, Aubaniac JM. Prothèse de hanche, du genou et sport Hip and knee replacement and sport. Rehabil Phys Med. 2004;47:382–8.

    CAS  Google Scholar 

  13. Aweid O, Melton J. Biomechanics of the knee. Orthop Trauma. 2019;33(4):224–30. https://doi.org/10.1016/j.mporth.2019.05.004.

    Article  Google Scholar 

  14. Vendittoli P, Blakeney W. Redefining knee replacement. Orthop Traumatol Surg Res. 2017; https://doi.org/10.1016/j.otsr.2017.09.003.

  15. Muckenhirn K, Chahla J, Laprade RF. Anatomy and biomechanics of the native knee and its relevance for total knee replacement. Chapter 1, Anatomy and biomechanics of the native knee and its relevance for total knee replacement, ISAKOS. 2017;3–15.

    Google Scholar 

  16. Wishart N, Beaumont R, Young E, Mccormack V, Swanson M. The NJR 11th Annual Report 2014 (December 2013). https://doi.org/10.13140/2.1.1191.2481.

  17. Bauman S, Williams D, Petruccelli D, Elliott W, De Beer J. Physical activity after total joint replacement: a cross-sectional survey. Clin J Sport Med. 2007;17(2):104–8.

    Article  Google Scholar 

  18. Bonnin M, Parratte JRLS, Bissery FZRBA, Bissery A. Can patients really do sport after TKA? Knee Surg Traumatol Arthrosc. 2010;18:853–62.

    Article  Google Scholar 

  19. Scott CEH, Howie CR, Macdonald D, Biant LC. Predicting dissatisfaction following total knee replacement. A prospective study of 1217 patients. J Bone Joint Surg Br. 2010;92(9):1253–8.

    Article  CAS  Google Scholar 

  20. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2019 Annual Report. Adelaide: AOA, 2019.

    Google Scholar 

  21. Athwal KK, Hunt NC, Davies AJ, Deehan DJ, Amis AA. Clinical biomechanics of instability related to total knee arthroplasty. Clin Biomech. 2014;29(2):119–28. https://doi.org/10.1016/j.clinbiomech.2013.11.004.

  22. Whiteside LA. Soft tissue balancing: the knee. J Arthroplasty. 2002;17(4 Suppl 1):23–7.

    Article  Google Scholar 

  23. Howell SM, Hull ML. Kinematic alignment in total knee arthroplasty. Chapter 121, Knee Arthroplasty 2011, p. 1255–69.

    Google Scholar 

  24. Broberg JS, Ndoja S, Macdonald SJ, Lanting BA, Teeter MG. Comparison of contact kinematics in posterior-stabilized and cruciate-retaining total knee arthroplasty at long-term follow-up. J Arthroplasty. 2020;35(1):272–7. https://doi.org/10.1016/j.arth.2019.07.046.

  25. Song SJ, Park CH, Bae DK. What to know for selecting cruciate-retaining or posterior-stabilized total knee arthroplasty. Clin Orthop Surg. 2019;11:142–50.

    Article  Google Scholar 

  26. Kang K, Koh Y, Son J, Kwon O, Lee J, Kwon SK. Comparison of kinematics in cruciate retaining and posterior stabilized for fixed and rotating platform mobile-bearing total knee arthroplasty with respect to different posterior tibial slope. Biomed Res Int. 2018; 5139074.

    Google Scholar 

  27. Cates HE, Komistek RD, Mahfouz MR, Schmidt MA, Anderle M. In vivo comparison of knee kinematics for subjects having either a posterior stabilized or cruciate retaining highflexion total knee arthroplasty. J Arthroplasty. 2008;23(7):1057–67.

    Google Scholar 

  28. Li G, Kernkamp WA, Rubash HE. In vitro and in vivo kinematics of total knee arthroplasty — a review of the research at the Orthopaedic Bioengineering Laboratory of the Massachusetts General Hospital (MGH). Ann Joint. 2016;1:20.

    Google Scholar 

  29. Singleton N, Nicholas B, Gormack N, Stokes A. Differences in outcome after cruciate retaining and posterior stabilized total knee arthroplasty. J Orthop Surg. 2019;27(2):1–8.

    Article  Google Scholar 

  30. Stiehl J, Komistek R, Dennis D, Paxson R, Hoff W. Fluoroscopic analysis of kinematics after posterior-cruciate-retaining knee arthroplasty. J Bone Joint Surg Br. 1995;77:884–9.

    Article  CAS  Google Scholar 

  31. Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;431:157–65.

    Article  Google Scholar 

  32. Healy BWL, Sharma S, Schwartz B, Iorio R. Athletic activity after total joint arthroplasty. J Bone Joint Surg. 2008;90:2245–52.

    Article  Google Scholar 

  33. Chatterji U, Ashworth M, Lewis P, Dobson P. Effect of total knee arthroplasty on recreational and sporting activity. ANZ J Surg. 2005;75:405–8.

    Article  Google Scholar 

  34. Healy WL, Iorio R, Lemos MJ. Athletic activity after total knee arthroplasty. Clin Orthop Relat Res. 2000;380:65–71.

    Article  Google Scholar 

  35. Chang MJ, Kim SH, Kang YG, Chang CB, Kim TK. Activity levels and participation in physical activities by Korean patients following total knee arthroplasty. BMC Musculoskelet Disord. 2014;15(1):2–7.

    Article  Google Scholar 

  36. Diduch D, Insall J, Scott W, Scuderi G, Font-Rodriguez D. Total knee replacement in young, active patients: long-term follow-up and functional outcome. J Bone Joint Surg. 1997;79(4):575–82.

    Article  CAS  Google Scholar 

  37. Hepperger C, Gföller P, Christian EA, Ulmer H, Herbst E, Fink C. Sports activity is maintained or increased following total knee arthroplasty. Knee Surg Sport Traumatol Arthrosc. 2018;26(5):1515–23.

    Article  Google Scholar 

  38. Levinger P, Menz HB, Morrow AD, Pod M, Feller JA, Bartlett JR, et al. Lower limb biomechanics in individuals with knee osteoarthritis before and after total knee arthroplasty surgery. J Arthroplasty. 2013;28(6):994–9. https://doi.org/10.1016/j.arth.2012.10.018.

  39. Andriacchi TP. Functional analysis of pre and post-knee surgery: total knee arthroplasty and ACL reconstruction. J Biomech Eng. 1993;115:575–81.

    Google Scholar 

  40. Naal FD, Impellizzeri FM, Leunig M. Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res. 2009;467(4):958–65.

    Google Scholar 

  41. Walton NP, Tr F, Lewis PL, Dobson PJ, Angel KR, Campbell DG. Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg. 2006;19(2):112–6.

    Article  Google Scholar 

  42. Mont MA, Rajadhyaksha AD, Marxen JL, Silberstein CE, Hungerford DS. Tennis after total knee arthroplasty. Am J Sports Med. 2002;30(2):163–6.

    Google Scholar 

  43. Huch K, Muller K, Sturmer T, Brenner H, Puhl W, Gunther K-P. Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis. 2005;64:1715–20.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sports Medicine Institute, Miranda, NSW, Australia

    A. Kropelnicki

  2. Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia

    D. A. Parker

  3. University of Sydney, Sydney, Australia

    D. A. Parker

Authors
  1. A. Kropelnicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. A. Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. A. Parker .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery Orthopaedic & Spine Institute, NorthShore University HealthSystem, Skokie, IL, USA

    Jason Koh

  2. IRCCS – Rizzoli Orthopaedic Institute – 2nd Orthopaedic and Trauma Unit, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

  3. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Ryosuke Kuroda

  4. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy

    Umile Giuseppe Longo

  5. Department of Orthopaedic Surgery, Orthopaedic & Spine Institute, NorthShore University Health System, Evanston, IL, USA

    Farid Amirouche

Rights and permissions

Reprints and permissions

Copyright information

© 2021 ISAKOS

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kropelnicki, A., Parker, D.A. (2021). Biomechanics of Cruciate Retaining and Posterior Stabilised Total Knee Arthroplasty and Return to Sports. In: Koh, J., Zaffagnini, S., Kuroda, R., Longo, U.G., Amirouche, F. (eds) Orthopaedic Biomechanics in Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-81549-3_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-81549-3_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81548-6

  • Online ISBN: 978-3-030-81549-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation