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The Journal of Bone and Joint Surgery (American) 84:S37-S42 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Exhibits

Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty

Scott A. Banks, PhD, Melinda K. Harman, MSc and W. Andrew Hodge, MD

Corresponding Author:
Scott A. Banks, PhD
The Biomotion Foundation, 1411 North Flagler Drive, Suite 9800, West Palm Beach, FL 33401. E-mail: banks@alum.mit.edu

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Smith and Nephew, Sulzer Medica, and Stryker. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The first 150 words of the full text of this article appear below.


   Introduction
 
Total knee replacements (TKR) are typically designed to accommodate 10° to 15° of hyperextension. However, many retrieved polyethylene tibial inserts, both from posterior cruciate ligament (PCL)-retaining and PCL-substituting TKRs, exhibit a high incidence of anterior wear on the tibial eminence or post. The mechanism for this anterior wear is not well understood. In addition, studies with fluoroscopic analysis have shown that some TKRs hyperextend during daily activities more than previously thought 1,2 .

The purpose of the studies in this exhibit was to answer the following research questions. What is the mechanism for anterior wear observed on retrieved polyethylene inserts? In well-functioning TKRs, how common is knee hyperextension during daily activities? Do TKRs hyperextend more than is appreciated through a standard physical examination?

Anterior Impingement Damage: A Common Finding in All Types of TKR Retrievals
Forty-eight retrieved tibial inserts were visually inspected for damage on the articular surface and the tibial eminence. Anterior impingement damage was a common finding, consistent with that reported . . . [Full Text of this Article]


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