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Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

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Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

Ryota Yamagami, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Takahiro Arakawa, MD, JAPAN Hiroshi Inui, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN

The University of Tokyo, Tokyo, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Bones

Diagnosis / Condition

Arthritis Osteoarthritis

Treatment / Technique

Arthroplasty Implant Total Joint Replacement

Patient Populations

Elderly

Summary: Intraoperative varus-valgus joint laxity patterns throughout a knee range of motion after bicruciate-stabilized total knee replacement, which were assessed using a navigation system, were associated with knee flexion angles and patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score and the patient satisfaction score in the 2011 Knee Society Score) at one year postoperatively.

Background

In recent-introduced robot-assisted total knee arthroplasties (TKAs) including bicruciate-stabilized (BCS) TKA, the mediolateral laxity under a varus-valgus force is used to determine the amount of bone resection and implant placement angle. However, the evidence regarding what laxity patterns should be aimed for to achieve better postoperative outcomes is still insufficient. This study aimed to clarify the relationship between the pattern of intraoperative varus-valgus laxity throughout a knee range of motion (ROM) after implant placement and postoperative clinical outcomes in BCSTKA.

Methods

One hundred and thirty-four patients [28 males and 106 females with a mean age of 72 years and a mean body mass index (BMI) of 24.7 kg/m2] who underwent mechanical axis aligned primary BCSTKA using an image-free computer navigation for primary varus osteoarthritis were included. After the final implantation and capsule closure, joint laxity (JL) under a maximum varus–valgus stress was recorded with navigation. The amount of change in varus and valgus angles from the unstressed mechanical axis were defined as the lateral and medial JL under a varus-valgus force (JLVV) respectively. The patients were categorized into three groups [Pattern (P) 1–3; P1, n=47; P2, n=55; P3, n=32] based on the medial and lateral JLVVs at a knee flexion of 10°, 30°, 60°, 90° and 120° using hierarchical cluster analysis. The JLVV patterns, the patients’ characteristics (age, gender, BMI and preoperative HKA), and the pre- and postoperative one-year ROM and patient-reported outcome measures (PROMs) [Knee injury and Osteoarthritis Outcome Score (KOOS) and the 2011 Knee Society Score (KSS) satisfaction score] were compared among the three clusters.

Results

There were no significant differences in patient background, preoperative ROM, KOOS and 2011 KSS satisfaction score among the three clusters.
Regarding JLVV patterns, P1 showed medial JLVV of 3° or more at knee flexion of 30°, 60° and 120°, all of which were significantly larger than P2 and P3 (p <0.01). The medial JLVVs in P2 were less than 3 degrees throughout the knee ROM without significant change, whereas the medial JLVV at 120° in P3 were smaller than the medial JLVV at 90° (p =0.02). On the other hand, the lateral JLVV in all clusters increased with knee flexion. In each cluster, the lateral JLVV showed the maximum value at 90° of knee flexion, and the values were 4° in P1, 6° in P2 and 10° in P3.
Regarding the postoperative one-year ROM, P2 and P3 had significantly better flexion angles than P1 (P1, 120°; P2, 128°; P3, 129°; p <0.01). Moreover, one-year postoperative KOOS symptom score (P1, 80; P2, 86; p =0.03) and the 2011 KSS satisfaction score (P1, 26; P2, 30; p <0.01) in P2 were better than those of P1.

Discussion

Patients with the stable medial JLVV less than 3° throughout entire knee ROM combined with the lateral JLVV of approximately 6° achieved better postoperative knee flexion angle and PROMs at postoperative one year in BCSTKA.

Conclusion

Intraoperative JLVV pattern throughout a knee ROM was associated with postoperative knee flexion angle and PROMs in BCSTKA.

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Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Lateral Unicompartmental Knee Arthroplasty (UKA) Showed a Lower Risk of Failure Compared to Medial Unicompartmental Knee Arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO) ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Barbara Bordini, Stat, ITALY Stefano Fratini, MD, ITALY Cristina Ancarani, Stat, ITALY Piero Agostinone, MD, ITALY Alberto Grassi, PhD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity ePoster Presentation Eiichi Nakamura, MD, PhD, JAPAN Nobukazu Okamoto, MD, PhD, JAPAN Hitoshi Ito, MD, PhD, JAPAN Tetsurou Masuda, MD, PhD, JAPAN Satoshi Hisanaga, MD, PhD, JAPAN Yasunari Oniki, MD, PhD, JAPAN
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
Effect of Restricted Kinematic Alignment Total Knee Arthroplasty on Coronal Plane Alignment Of The Ankle Joint ePoster Presentation Bartosz Michał Maciąg, MD, POLAND Marcin Łapiński, MD, POLAND Tomasz Mrozek, MD, POLAND Adrian Góralczyk, MD, POLAND Maciej Swiercz, MD, POLAND Grzegorz Maciąg, POLAND Krystian Żarnovsky, POLAND Olga Adamska, POLAND Artur Stolarczyk, MD, PhD, POLAND
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty ePoster Presentation James Gill, MB BChir, BSc, FRCS, UNITED KINGDOM McMeniman J Peter, AUSTRALIA Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, AUSTRALIA Daniel Johnson Brimm, BSc, MD, AUSTRALIA Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA

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Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

Background

Methods

Results

Discussion

Conclusion

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Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty.

Background

Methods

Results

Discussion

Conclusion

More 2023 ISAKOS Congress Content