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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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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
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
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 Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN

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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