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Navigation-based femorotibial rotation pattern correlated with flexion angle after total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate whether intraoperative kinematics obtained by navigation systems can be divided into several kinematic patterns and to assess the correlation between the intraoperative kinematics with maximum flexion angles before and after total knee arthroplasty (TKA).

Method

Fifty-four posterior-stabilised (PS) TKA implanted using an image-free navigation system were evaluated. At registration and after implantation, tibial internal rotation angles at maximum extension, 30°, 45°, 60°, 90°, and maximum flexion were collected. The rotational patterns were divided into four groups and were examined the correlation with maximum flexion before and after operation.

Results

Tibial internal rotation from 90° of flexion to maximum flexion at registration was correlated with maximum flexion angles pre- and postoperatively. The four groups showed statistically different kinematic patterns. The group with tibial external rotation up to 90° of flexion, following tibial internal rotation at registration, achieved better flexion angles, compared to those of another groups (126.7° ± 12.0°, p < 0.05). The group with tibial external rotation showed the worst flexion angles (80.0° ± 40.4°, p < 0.05). Furthermore, the group with limited extension showed worse flexion angles (111.6° ± 8.9°, p < 0.05).

Conclusion

Navigation-based kinematic patterns found at registration predict postoperative maximum flexion angle in PS TKA. Navigation-based kinematics can be useful information during TKA surgery.

Level of evidence

Diagnostic studies, development of diagnostic criteria in a consecutive series of patients and a universally applied “gold” standard, Level II.

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References

  1. Akagi M, Mori S, Nishimura S, Nishimura A, Asano T, Hamanishi C (2005) Variability of extraarticular tibial rotation references for total knee arthroplasty. Clin Orthop Relat Res 436:172–176

    Article  PubMed  Google Scholar 

  2. Casino D, Zaffagnini S, Martelli S, Lopomo N, Bignozzi S, Iacono F, Russo A, Marcacci M (2009) Intraoperative evaluation of total knee replacement: kinematic assessment with a navigation system. Knee Surg Sports Traumatol Arthrosc 17(4):369–373

    Article  PubMed  Google Scholar 

  3. Cavaignac E, Carpentier K, Pailhe R, Luyckx T, Bellemans J (2014) The role of the deep medial collateral ligament in controlling rotational stability of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3095-1

    Google Scholar 

  4. Chinzei N, Ishida K, Matsumoto T, Kuroda Y, Kitagawa A, Kuroda R, Akisue T, Nishida K, Kurosaka M, Tsumura N (2014) Evaluation of patellofemoral joint in ADVANCE Medial-pivot total knee arthroplasty. Int Orthop 38(3):509–515

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cromie MJ, Siston RA, Giori NJ, Delp SL (2008) Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty. J Orthop Res 26(11):1494–1499

    Article  PubMed  Google Scholar 

  6. Dennis DA, Komistek RD, Hoff WA, Gabriel SM (1996) In vivo knee kinematics derived using an inverse perspective technique. Clin Orthop Relat Res 331:107–117

    Article  PubMed  Google Scholar 

  7. Dennis DA, Komistek RD, Mahfouz MR, Walker SA, Tucker A (2004) A multicenter analysis of axial femorotibial rotation after total knee arthroplasty. Clin Orthop Relat Res 428:180–189

    Article  PubMed  Google Scholar 

  8. Fujimoto E, Sasashige Y, Masuda Y, Hisatome T, Eguchi A, Masuda T, Sawa M, Nagata Y (2013) Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 21(12):2704–2712

    Article  PubMed  Google Scholar 

  9. Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, Iguchi T, Kurosaka M, Kuroda R (2011) Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(7):1107–1112

    Article  PubMed  Google Scholar 

  10. Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20(7):832–839

    Article  PubMed  Google Scholar 

  11. Kanekasu K, Banks SA, Honjo S, Nakata O, Kato H (2004) Fluoroscopic analysis of knee arthroplasty kinematics during deep flexion kneeling. J Arthroplasty 19(8):998–1003

    Article  PubMed  Google Scholar 

  12. Kim SH, Lee HJ, Jung HJ, Lee JS, Kim KS (2013) Less femoral lift-off and better femoral alignment in TKA using computer-assisted surgery. Knee Surg Sports Traumatol Arthrosc 21(10):2255–2262

    Article  PubMed  Google Scholar 

  13. Klein GR, Parvizi J, Rapuri VR, Austin MS, Hozack WJ (2004) The effect of tibial polyethylene insert design on range of motion: evaluation of in vivo knee kinematics by a computerized navigation system during total knee arthroplasty. J Arthroplasty 19(8):986–991

    PubMed  Google Scholar 

  14. Koh IJ, Chang CB, Kang YG, Seong SC, Kim TK (2013) Incidence, predictors, and effects of residual flexion contracture on clinical outcomes of total knee arthroplasty. J Arthroplasty 28(4):585–590

    Article  PubMed  Google Scholar 

  15. Komistek RD, Dennis DA, Mahfouz M (2003) In vivo fluoroscopic analysis of the normal human knee. Clin Orthop Relat Res 410:69–81

    Article  PubMed  Google Scholar 

  16. Martin A, Wohlgenannt O, Prenn M, Oelsch C, von Strempel A (2007) Imageless navigation for TKA increases implantation accuracy. Clin Orthop Relat Res 460:178–184

    PubMed  Google Scholar 

  17. Massin P, Petit A, Odri G, Ducellier F, Sabatier C, Lautridou C, Cappelli M, Hulet C, Canciani JP, Letenneur J, Burdin P, Societe d’orthopedie de lo (2009) Total knee arthroplasty in patients with greater than 20 degrees flexion contracture. Orthop Traumatol Surg Res 95(4 Suppl 1):S7–S12

    Article  PubMed  CAS  Google Scholar 

  18. Matsuda S, Kawahara S, Okazaki K, Tashiro Y, Iwamoto Y (2013) Postoperative alignment and ROM affect patient satisfaction after TKA. Clin Orthop Relat Res 471(1):127–133

    Article  PubMed  PubMed Central  Google Scholar 

  19. Matsuzaki T, Matsumoto T, Kubo S, Muratsu H, Matsushita T, Kawakami Y, Ishida K, Oka S, Kuroda R, Kurosaka M (2013) Tibial internal rotation is affected by lateral laxity in cruciate-retaining total knee arthroplasty: an intraoperative kinematic study using a navigation system and offset-type tensor. Knee Surg Sports Traumatol Arthrosc 22(3):615–620

    Article  PubMed  Google Scholar 

  20. Matsuzaki T, Matsumoto T, Muratsu H, Kubo S, Matsushita T, Kawakami Y, Ishida K, Oka S, Kuroda R, Kurosaka M (2013) Kinematic factors affecting postoperative knee flexion after cruciate-retaining total knee arthroplasty. Int Orthop 37(5):803–808

    Article  PubMed  PubMed Central  Google Scholar 

  21. Ngai V, Wimmer MA (2009) Kinematic evaluation of cruciate-retaining total knee replacement patients during level walking: a comparison with the displacement-controlled ISO standard. J Biomech 42(14):2363–2368

    Article  PubMed  PubMed Central  Google Scholar 

  22. Seon JK, Park JK, Shin YJ, Seo HY, Lee KB, Song EK (2011) Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining versus substituting designs. Knee Surg Sports Traumatol Arthrosc 19(12):2016–2022

    Article  PubMed  Google Scholar 

  23. Siston RA, Giori NJ, Goodman SB, Delp SL (2006) Intraoperative passive kinematics of osteoarthritic knees before and after total knee arthroplasty. J Orthop Res 24(8):1607–1614

    Article  PubMed  Google Scholar 

  24. Tei K, Ishida K, Matsumoto T, Kubo S, Sasaki H, Shibanuma N, Akisue T, Nishida K, Kurosaka M, Kuroda R (2012) Novel image-matching software for postoperative evaluation after TKA. Orthopedics 35(12):e1711–e1715

    Article  PubMed  Google Scholar 

  25. Victor J, Banks S, Bellemans J (2005) Kinematics of posterior cruciate ligament-retaining and -substituting total knee arthroplasty: a prospective randomised outcome study. J Bone Joint Surg Br 87(5):646–655

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe, 657-0068, Japan

    Kazunari Ishida, Nao Shibanuma & Hiroshi Sasaki

  2. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, Kobe, 650-0017, Japan

    Tomoyuki Matsumoto, Koji Takayama, Tokio Matsuzaki, Ryosuke Kuroda & Masahiro Kurosaka

  3. Department of Orthopaedic Surgery, Chibune General Hosipital, 2-2-45, Tsukuda, Nishi-yodogawa, Osaka, 555-0001, Japan

    Katsumasa Tei

Authors
  1. Kazunari Ishida
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  2. Nao Shibanuma
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  3. Tomoyuki Matsumoto
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  4. Hiroshi Sasaki
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  5. Koji Takayama
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  6. Tokio Matsuzaki
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  7. Katsumasa Tei
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  8. Ryosuke Kuroda
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  9. Masahiro Kurosaka
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Correspondence to Kazunari Ishida.

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Ishida, K., Shibanuma, N., Matsumoto, T. et al. Navigation-based femorotibial rotation pattern correlated with flexion angle after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 24, 89–95 (2016). https://doi.org/10.1007/s00167-014-3340-7

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  • DOI: https://doi.org/10.1007/s00167-014-3340-7

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