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The Future of T.K.R.

Most current TKR designs perform reasonably

well- but are far from providing anything like

normal knee function. We will always be limi-

ted by the usage of man-made materials in

implants, as compared to in vivo living tissues,

and the significantly impaired proprioception

in replaced knees. However in the history to

TKR the closer the designs have become to a

natural knee the better their performance [eg

the advances from fixed hinges to total condy-

lar designs].

In the light of our findings clearly current total

condylar designs can evolve considerably.

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JOURNÉES LYONNAISES DE CHIRURGIE DU GENOU

164

REFERENCES

[1] P JOHAL, AWILLIAMS, PWRAGG

et al.

Tibio-femo-

ral movement in the living knee. A study of weight-bearing

and non-weight-bearing knee kinematics using ‘interventio-

nal’ MRI.

Journal of Biomechanics 2005; 38: 269-76.

[2] PINSKEROVA V, JOHAL P, NAKAGAWA S

et al.

The

motion of the joint surface contact areas is not the same as

that of the condyles during flexion of the knee.

JBJS[Br]

2004; 86[B]: 925-31.

[3] A WILLIAMS, M LOGAN. Understanding tibio-femo-

ral motion.

The Knee 2004; 11: 81-8.

[4] HILL P, VEDI V, WILLIAMS A

et al

. Tibio-femoral

movement 2: the loaded and unloaded living knee studied

by MRI.

JBJS [Br] 2000; 82-B: 1196-8.

Fig. 2 : The same lines as shown in figure 1. These measurements were made during knee

flexion with tibial external rotation. Thereis no resultant axial rotation.