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Unicompartmental knee arthroplasty cannot restore the functional flexion axis of a living knee to normal

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

Abstract

Purpose

The purpose of this study was to investigate the hypothesis that a medial unicompartmental knee arthroplasty might restore the functional flexion axis of a knee to normal. The flexion axis can be indirectly identified by tracking the vertical translation of anatomic landmarks that basically move around the flexion axis during a knee motion. If a unicompartmental knee could help restore the normal flexion axis, the anatomic landmarks after the arthroplasty would show the vertical translation similar to those of normal knees during a knee flexion.

Methods

While performing a squatting motion, the kinematics of 17 knees were determined before and after a medial unicompartmental arthroplasty to calculate the vertical translation of a clinical epicondylar axis, using a three- to two-dimensional registration technique through a single-plane fluoroscopic system incorporating a biplanar static radiography. The results were compared with a normal data, and a statistical analysis including a two-way repeated-measured analysis of variance was performed.

Results

For the medial end, from 10° to 100° knee flexion, normal, osteoarthritic, and unicompartmental knees had the average superior vertical translation of 7.3 ± 4.2, 4.3 ± 7.2, and 2.4 ± 3.1 mm, respectively, with statistical significance between normal and unicompartmental knees (p < 0.001). The vertical translation did not return to normal post-implantation.

Conclusions

A unicompartmental knee could not reproduce the normal flexion axis. As for clinical relevance, the changes of the implant design and surgical procedure may be necessary to obtain the normal flexion axis reproducing a normal motion.

Level of evidence

IV.

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Acknowledgments

This study would have been impossible without the cooperation of the Department of Radiology, Niigata Medical Center and Niigata University Hospital. The authors would like to thank all staff members of the department. The authors would also like to thank all staff members of LEXI Corporation, Tokyo, Japan, for their technical support.

Conflict of interest

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata City, Niigata, Japan

    Tomoharu Mochizuki, Takashi Sato, Satoshi Watanabe & Yoshio Koga

  2. Department of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata City, Niigata, Japan

    Tomoharu Mochizuki, Osamu Tanifuji, Hiroshi Yamagiwa & Naoto Endo

  3. Department of Orthopaedic Surgery, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan

    Tomoharu Mochizuki

  4. Department of Health Sciences, Niigata University School of Medicine, Niigata City, Niigata, Japan

    Koichi Kobayashi

  5. Department of Health and Sports, Niigata University of Health and Welfare, Niigata City, Niigata, Japan

    Go Omori

Authors
  1. Tomoharu Mochizuki
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  2. Takashi Sato
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  3. Osamu Tanifuji
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  4. Koichi Kobayashi
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  5. Hiroshi Yamagiwa
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  7. Yoshio Koga
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  8. Go Omori
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  9. Naoto Endo
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Correspondence to Tomoharu Mochizuki.

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Mochizuki, T., Sato, T., Tanifuji, O. et al. Unicompartmental knee arthroplasty cannot restore the functional flexion axis of a living knee to normal. Knee Surg Sports Traumatol Arthrosc 23, 3736–3742 (2015). https://doi.org/10.1007/s00167-014-3296-7

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  • DOI: https://doi.org/10.1007/s00167-014-3296-7

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