{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T23:49:03Z","timestamp":1777247343073,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Kinematic patterns of knees after total knee arthroplasty (TKA) are different from those of healthy knees. We hypothesised that these changes cause a relevant shift in the medial and lateral epicondyles and, consequently, the insertion sites of the collateral ligaments. Any alterations, however, violate the law of Burmester, which states a close relation between the course of the collateral and cruciate ligaments, and the articular surfaces. Methods: Ten healthy knees of whole body cadavers were investigated. The positions of the medial and lateral epicondyles in relation to the tibia were compared before and after cruciate retaining fixed bearing TKA between 0 and 90\u00b0 of flexion using a navigational device. Results: After TKA, the medial and lateral epicondyles significantly shifted laterally (~3\u20135mm) between 0\u00b0 and 40\u00b0 of flexion. Additionally, the lateral epicondyle was located significantly more dorsal (~3\u20135mm) during 0\u00b0 and 20\u00b0 of flexion and significantly shifted proximally (~2.5\u20133mm) between 0\u00b0 and 30\u00b0 of flexion. Conclusions: By changing the epicondylar positions relative to the articular surfaces, the law of Burmester is violated in the present study setting. This might explain the impairment in motion, instability, or mid-flexion instability and the persistent pain in the knees after TKA.<\/jats:p>","DOI":"10.3390\/jpm13010036","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T04:42:47Z","timestamp":1672116167000},"page":"36","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Total Knee Arthroplasty Violates the Law of Burmester\u2014A Biomechanical Investigation"],"prefix":"10.3390","volume":"13","author":[{"given":"G\u00fcnther","family":"Maderbacher","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Keshmiri","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Robert","family":"Springorum","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"M\u00f6senbacher","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Leoben, 8700 Leoben, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Grifka","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Baier","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"ref_1","unstructured":"Weber, W., and Weber, F. 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