This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bellemans, J. Articles by Moemans, A. Search for Related Content PubMed PubMed Citation Articles by Bellemans, J. Articles by Moemans, A.

Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty

INFLUENCE OF POSTERIOR CONDYLAR OFFSET

¹ Department of Orthopaedic Surgery, Weligerveld 1, 3012 Pellenberg, Belgium.
² 1411 N Flagler Drive, Suite 9800, 33401 West Palm Beach, Florida, USA.
³ Az St Lucas, St Lucaslaan 29, 8310 Brugge, Belgium.

Correspondence should be sent to Professor J. Bellemans.

Our purpose was to determine the mechanism which allows the maximum knee flexion in vivo after a posterior-cruciate-ligament (PCL)-retaining total knee arthroplasty.

Using three-dimensional computer-aided design videofluoroscopy of deep squatting in 29 patients, we determined that in 72% of knees, direct impingement of the tibial insert posteriorly against the back of the femur was the factor responsible for blocking further flexion.

In view of this finding we defined a new parameter termed the ‘posterior condylar offset’. In 150 consecutive arthroplasties of the knee, the magnitude of posterior condylar offset was found to correlate with the final range of flexion.

This article has been cited by other articles:

				T.-H. Kim, D.-H. Lee, and S.-I. Bin The NexGen LPS-flex to the knee prosthesis at a minimum of three years J Bone Joint Surg Br, October 1, 2008; 90-B(10): 1304 - 1310. [Abstract] [Full Text] [PDF]

				R. W. Nutton, M. L. van der Linden, P. J. Rowe, P. Gaston, and F. A. Wade A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components J Bone Joint Surg Br, January 1, 2008; 90-B(1): 37 - 42. [Abstract] [Full Text] [PDF]

				H. S. Han, S.-B. Kang, and K. S. Yoon High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement J Bone Joint Surg Br, November 1, 2007; 89-B(11): 1457 - 1461. [Abstract] [Full Text] [PDF]

				B. Jeffcote, R. Nicholls, A. Schirm, and M. S. Kuster The variation in medial and lateral collateral ligament strain and tibiofemoral forces following changes in the flexion and extension gaps in total knee replacement: A LABORATORY EXPERIMENT USING CADAVER KNEES J Bone Joint Surg Br, November 1, 2007; 89-B(11): 1528 - 1533. [Abstract] [Full Text] [PDF]

				B. M. Hanratty, N. W. Thompson, R. K. Wilson, and D. E. Beverland The influence of posterior condylar offset on knee flexion after total knee replacement using a cruciate-sacrificing mobile-bearing implant J Bone Joint Surg Br, July 1, 2007; 89-B(7): 915 - 918. [Abstract] [Full Text] [PDF]

				H. P. Delport, S. A. Banks, J. De Schepper, and J. Bellemans A kinematic comparison of fixed- and mobile-bearing knee replacements J Bone Joint Surg Br, August 1, 2006; 88-B(8): 1016 - 1021. [Abstract] [Full Text] [PDF]

				Y. Matsuda, Y. Ishii, H. Noguchi, and R. Ishii Varus-valgus balance and range of movement after total knee arthroplasty J Bone Joint Surg Br, June 1, 2005; 87-B(6): 804 - 808. [Abstract] [Full Text] [PDF]

				J. Victor, S. Banks, and J. Bellemans Kinematics of posterior cruciate ligament-retaining and -substituting total knee arthroplasty: A PROSPECTIVE RANDOMISED OUTCOME STUDY J Bone Joint Surg Br, May 1, 2005; 87-B(5): 646 - 655. [Abstract] [Full Text] [PDF]