Mid-term outcomes of a kinematically designed cruciate retaining total knee arthroplasty

BACKGROUND Advances in implant material and design have allowed for improvements in total knee arthroplasty(TKA)outcomes.A cruciate retaining(CR)TKA provides the least constraint of TKA designs by preserving the native posterior cruciate ligament.Limited research exists that has examined clinical outcomes or patient reported outcome measures(PROMs)of a large cohort of patients undergoing a CR TKA utilizing a kinematically designed implant.It was hypothesized that the studied CR Knee System would demonstrate favorable outcomes and a clinically significant improvement in pain and functional scores.AIM To assess both short-term and mid-term clinical outcomes and PROMs of a novel CR TKA design.METHODS A retrospective,multi-surgeon study identified 255 knees undergoing a TKA utilizing a kinematically designed CR Knee System(JOURNEY™II CR;Smith and Nephew,Inc.,Memphis,TN)at an urban,academic medical institution between March 2015 and July 2021 with a minimum of two-years of clinical follow-up with an orthopedic surgeon.Patient demographics,surgical information,clinical outcomes,and PROMs data were collected via query of electronic medical records.The PROMs collected in the present study included the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement(KOOS JR)and Patient-Reported Outcomes Measurement Information System(PROMIS■)scores.The significance of improvements in mean PROM scores from preoperative scores to scores collected at six months and two-years postoperatively was analyzed using Independent Samples t-tests.RESULTS Of the 255 patients,65.5%were female,43.8%were White,and patients had an average age of 60.6 years.Primary osteoarthritis(96.9%)was the most common primary diagnosis.The mean surgical time was 105.3 minutes and mean length of stay was 2.1 d with most patients discharged home(92.5%).There were 18 emergency department(ED)visits within 90 d of surgery resulting in a 90 d ED visit rate of 7.1%,including a 2.4%orthopedic-related ED visit rate and a 4.7%non-orthopedic-related ED visit rate.There were three(1.2%)hospital readmissions within 90 d postoperatively.With a mean time to latest follow-up of 3.3 years,four patients(1.6%)required revision,two for arthrofibrosis,one for aseptic femoral loosening,and one for peri-prosthetic joint infection.There were significant improvements in KOOS JR,PROMIS Pain Intensity,PROMIS Pain Interference,PROMIS Mobility,and PROMIS Physical Health from preoperative scores to six month and two-year postoperative scores.CONCLUSION The evaluated implant is an effective,novel design offering excellent outcomes and low complication rates.At a mean follow up of 3.3 years,four patients required revisions,three aseptic and one septic,resulting in an overall implant survival rate of 98.4%and an aseptic survival rate of 98.8%.The results of our study demonstrate the utility of this kinematically designed implant in the setting of primary TKA.

MEASURING AND MODELING OF THE MECHANICAL PROPERTIES OF COMPOSITE BEARING PAD MADE OF PLASTIC MATRIX AND FINE BRONZE ELASTIC SPRINGS

The viscoelastic properties of the normal PTFE plastic and strengthened PTFEplastic for bearing pad are measured. The mechanical properties of the composite material forbearing pad, which is made of the aforementioned plastics as matrix reinforced by fine bronzeelastic springs, are modeled and relaxation modulus of the material are presented. The differencebetween these two kinds of PTFE is studied. The results show that the complex modulus of PTFEplastics for bearing pad is higher than that of normal PTFE plastics.

Application of Bionic Tribology in Water-Lubricated Bearing:A Review

Water-lubricated bearing has become the development trend in the future because of its economy and environmental friendliness.The poor friction performance under low speed and heavy load seriously limits the popularization and application of water-lubricated bearings.Learning from nature,the phenomenon of low friction and wear in nature has aroused great interest of scientists,and a lot of research has been carried out from mechanism analysis to bionic application.In this review,our purpose is to provide guiding methods and analysis basis for the bionic design and theoretical research of anti-friction and anti-wear of water-lubricated bearings.The development of water-lubricated bearing materials are described.Some typical examples of natural friction reduction and drag reduction are introduced in detail,and several representative preparation methods are listed.Finally,the application status of bionic tribology in water-lubricated bearings is summarized,and the future development direction of water-lubricated bearings is prospected.