Partial restoration of knee kinematics in severe valgus deformity using the medial-pivot total knee arthroplasty View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-11-29

AUTHORS

Atsushi Kitagawa, Kazunari Ishida, Takaaki Chin, Nobuhiro Tsumura, Tetsushiro Iguchi

ABSTRACT

PurposeThe objectives of the study were to examine knee kinematics in knees with severe valgus deformities and to compare pre- and post-operative knee kinematics for the same subjects implanted with medial-pivot total knee arthroplasty (TKA).MethodsSeven subjects with severe valgus deformities due to osteoarthritis (OA) or rheumatoid arthritis (RA) were enrolled in the prospective study. Prior to TKA, three-dimensional (3D) kinematics were assessed by 3D to 2D registration technique using the image matching software ‘Knee Motion’, under in vivo, weight-bearing conditions. Postoperatively, each subject again performed the same motion under fluoroscopic surveillance.ResultsPreoperative kinematics demonstrated external rotation of tibias from extension to flexion, and small posterior femoral translations dominated in the medial condyle associated with anterior slides during partial range of motion. Postoperatively, these non-physiological tibial rotations were restored, and most subjects exhibited small internal rotations of tibias. On average, preoperative tibial internal rotation was −4.7° ± 7.6° from full extension to maximum flexion, and the angle was 4.8° ± 3.1° postoperatively (p = 0.01). In addition, small amounts of posterior translation of the lateral condyle and anterior translation of the medial condyle were confirmed in most subjects postoperatively.ConclusionsThe study showed that the preoperative kinematic pattern established in severe valgus deformity was different from the physiological knee pattern. In addition, post-operative results suggest that the non-physiological kinematics were partially restored after TKA by using the prosthesis design even in the absence of the posterior cruciate ligament (PCL) and the cam–post mechanism.Level of evidenceII. More... »

PAGES

1599-1606

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-012-2315-9

DOI

http://dx.doi.org/10.1007/s00167-012-2315-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1020276091

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23188499


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