Kinematic conflict Reproduction of normal knee biomechanics- reduction of contact forces Surfaces convex to flat produce high contact forces but have freedom in torsion & reduced strain to PCL during posterior femoral condyle movement Concave to convex reduced contact forces & reduced torsion
Mobile bearing polyethylene Restricts torsion between femorotibial joint allowing torsion between tibial plateau and polyethylene Contact surface increases very much Contact forces decrease respectively Closer to normal posterior movement of femoral condyles, at least during the first degrees of flexion Callaghan et al, JBJS (Am)
Μobile bearing Allow the torques and shear forces of gait to be transferred to soft tissues in a fashion similar to normal knee. Soft tissue strengthening – remodeling during rehabilitation Better patellar tracking Rotation of polyethylene can forgive SMALL errors of orientation Sansone et al,j arthroplasty 2004
Surgical preparation 1.5gr cefuroxim on admission. Antibiotic regime for 3 days post op Skin preparation with Betadine scrub, Betadine solution (3 times) starting from the foot Strict rules in theatres room in all levels
Infections 10 superficial postoperative infections which were treated with antibiotics No revisions because of infection
Follow up Patients followed up clinically and radiologically in 6 weeks, 6 months, 1 year and periodically every 2 years 10-20% of the patients were not examined after the two year follow up unless there was a problem
Revisions One LCS and one Genesis II because of aseptic loosening of femoral component Two revisions because of trauma- supracondylar femoral fracture in one and tibial fracture in the second One Polyethylene dislocation
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