Tibial internal rotation is affected by lateral laxity in cruciate-retaining total knee arthroplasty: an intraoperative kinematic study using a navigation ... View Full Text


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Article Info

DATE

2013-08-15

AUTHORS

Tokio Matsuzaki, Tomoyuki Matsumoto, Seiji Kubo, Hirotsugu Muratsu, Takehiko Matsushita, Yohei Kawakami, Kazunari Ishida, Shinya Oka, Ryosuke Kuroda, Masahiro Kurosaka

ABSTRACT

PurposeThe purpose of this study was to test the hypothesis that intraoperative soft-tissue balance assessed by an offset-type tensor influences post-operative knee kinematics after cruciate-retaining (CR) total knee arthroplasty (TKA).MethodsThe influence of intraoperative soft-tissue balance on knee kinematics in CR-TKA was retrospectively analysed in 30 patients. Intraoperative soft-tissue balance parameters such as varus angle (varus ligament balance), joint component gap (centre gap), and medial and lateral compartment gaps were measured in the navigation system while applying 40-lb joint distraction force at 0°, 10°, 30°, 60°, 90°, and 120° of knee flexion using an offset-type tensor with the patella reduced. Tibial internal rotation and tibial anterior translation were measured as the differences between the values at 60° and 120° of flexion using the navigation system. Correlations between the soft-tissue parameters and post-operative knee kinematics were analysed.ResultsThe varus ligament balance was positively correlated with tibial internal rotation at 60° and 90° of flexion (R = 0.54, P < 0.05; R = 0.60, P < 0.01, respectively). Furthermore, the joint component gap was positively correlated with tibial internal rotation at 90° of flexion (R = 0.44, P < 0.05), and the lateral compartment gap was positively correlated with tibial internal rotation at 60°, 90°, and 120° of knee flexion.ConclusionsThe intraoperative varus ligament balance and joint component gap values were factors that predicted post-operative knee kinematics after CR-TKA. Lateral laxity at mid-to-deep knee flexion plays a significant role in tibial internal rotation.Level of evidenceIII. More... »

PAGES

615-620

References to SciGraph publications

  • 2011-11-05. Less femorotibial rotation and AP translation in deep-dished total knee arthroplasty. An intraoperative kinematic study using navigation in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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  • 2011-07-01. Influence of intra-operative joint gaps on post-operative flexion angle in posterior cruciate-retaining total knee arthroplasty in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-03-23. Sagittal plane kinematics of fixed- and mobile-bearing total knee replacements in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-01-25. In vivo function of posterior cruciate ligament before and after posterior cruciate ligament-retaining total knee arthroplasty in INTERNATIONAL ORTHOPAEDICS
  • 2010-04-30. Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs in INTERNATIONAL ORTHOPAEDICS
  • 2009-11. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses in BEHAVIOR RESEARCH METHODS
  • 2008-12-20. Intraoperative evaluation of total knee replacement: kinematic assessment with a navigation system in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-05-30. Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-10-27. Soft tissue balance using the tibia first gap technique with navigation system in cruciate-retaining total knee arthroplasty in INTERNATIONAL ORTHOPAEDICS
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00167-013-2627-4

    DOI

    http://dx.doi.org/10.1007/s00167-013-2627-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1047668122

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23948722


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    32 schema:description PurposeThe purpose of this study was to test the hypothesis that intraoperative soft-tissue balance assessed by an offset-type tensor influences post-operative knee kinematics after cruciate-retaining (CR) total knee arthroplasty (TKA).MethodsThe influence of intraoperative soft-tissue balance on knee kinematics in CR-TKA was retrospectively analysed in 30 patients. Intraoperative soft-tissue balance parameters such as varus angle (varus ligament balance), joint component gap (centre gap), and medial and lateral compartment gaps were measured in the navigation system while applying 40-lb joint distraction force at 0°, 10°, 30°, 60°, 90°, and 120° of knee flexion using an offset-type tensor with the patella reduced. Tibial internal rotation and tibial anterior translation were measured as the differences between the values at 60° and 120° of flexion using the navigation system. Correlations between the soft-tissue parameters and post-operative knee kinematics were analysed.ResultsThe varus ligament balance was positively correlated with tibial internal rotation at 60° and 90° of flexion (R = 0.54, P < 0.05; R = 0.60, P < 0.01, respectively). Furthermore, the joint component gap was positively correlated with tibial internal rotation at 90° of flexion (R = 0.44, P < 0.05), and the lateral compartment gap was positively correlated with tibial internal rotation at 60°, 90°, and 120° of knee flexion.ConclusionsThe intraoperative varus ligament balance and joint component gap values were factors that predicted post-operative knee kinematics after CR-TKA. Lateral laxity at mid-to-deep knee flexion plays a significant role in tibial internal rotation.Level of evidenceIII.
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