Preoperative knee deformity and kinematics impact postoperative knee kinematics in total knee arthroplasty.

Autor: Seito N; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan., Onodera T; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan., Kasahara Y; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan., Kondo E; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan., Iwasaki N; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan., Majima T; Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan; Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5, Senndagi, Bunkyo-ku, Tokyo 113-8603, Japan. Electronic address: t-kmajima@nms.ac.jp.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2017 Dec; Vol. 24 (6), pp. 1462-1468. Date of Electronic Publication: 2017 Sep 30.
DOI: 10.1016/j.knee.2017.08.056
Abstrakt: Background: The purpose of this study was to evaluate the relationship between the preoperative knee deformity/kinematic pattern and the postoperative knee kinematic pattern in posterior cruciate ligament substituting (PS)-total knee arthroplasty (TKA).
Methods: This study involved 39 patients with medial osteoarthritis who underwent a primary PS-TKA using a computed-tomography-based navigation system. All the operations were performed by a single surgeon using a subvastus approach, modified gap technique and the same PS type of prosthesis (Genesis II™ total knee system, Smith & Nephew, Memphis, TN, USA). Knee deformity, kinematic pattern after capsule incision (preoperative knee kinematics), and kinematic pattern after implantation (postoperative knee kinematics) in PS-TKA were measured. Kinematic patterns were divided into two groups: a medial pivot group and a non-medial pivot group.
Results: Preoperative varus knee deformity was significantly larger in the non-medial pivot group than in the medial pivot group (femorotibial angle: 184.7±6.4° vs. 180.8±3.9°, P<0.05). In addition, preoperative knee kinematics were conserved postoperatively, at a rate of 82% (P<0.01).
Conclusions: The severity of varus knee deformity and the preoperative knee kinematic pattern might have affected the postoperative knee kinematics in PS-TKA. This must be confirmed with a randomized controlled trial on a large population study.
Level of Evidence: case control study, Level III.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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