Intraoperative posterior movement of the tibia at 90° of flexion predicts worse postoperative flexion angles in cruciate-substituting total knee arthroplasty

Purpose To investigate the correlation between intraoperative tibiofemoral anteroposterior changes at 90° of flexion and postoperative maximum flexion angles in navigated cruciate-substituting TKA. The hypothesis of this study was that intraoperative tibiofemoral anteroposterior changes at 90° of fl...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-09, Vol.28 (9), p.2816-2822
Main Authors: Inokuchi, Takao, Ishida, Kazunari, Takayama, Koji, Shibanuma, Nao, Hayashi, Shinya, Kurosaka, Masahiro, Kuroda, Ryosuke, Matsumoto, Tomoyuki
Format: Article
Language:English
Subjects:
Aged
Arthroplasty (knee)
Arthroplasty, Replacement, Knee
Biocompatibility
Biomechanical Phenomena
Biomedical materials
Comparative studies
Correlation
Female
Humans
Inserts
Joint surgery
Kinematics
Knee
Knee Joint - physiology
Knee Joint - surgery
Male
Medicine
Medicine & Public Health
Movement
Navigation systems
Orthopedics
Osteoarthritis
Osteoarthritis - surgery
Posterior Cruciate Ligament - physiology
Posterior Cruciate Ligament - surgery
Postoperative Period
Range of Motion, Articular
Retrospective Studies
Rotation
Surgical implants
Tibia
Tibia - physiology
Tibia - surgery
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Summary:Purpose To investigate the correlation between intraoperative tibiofemoral anteroposterior changes at 90° of flexion and postoperative maximum flexion angles in navigated cruciate-substituting TKA. The hypothesis of this study was that intraoperative tibiofemoral anteroposterior changes at 90° of flexion indirectly reflect posterior cruciate ligament (PCL) function and associate with postoperative maximum flexion angles. Methods Fifty-five consecutive patients with varus osteoarthritis treated with primary TKA were retrospectively analysed. All patients received the same type of implant, placed with an image-free navigation system. The PCL was retained, and cruciate-substituting inserts were used in all cases. The mean follow-up was 44 ± 8 months. The preoperative and postoperative kinematics were measured intraoperatively with a navigation system, and the preoperative and postoperative tibiofemoral anteroposterior positions at 90° of flexion were determined. The correlation between intraoperative anteroposterior position changes and postoperative maximum flexion angles was investigated. The correlation between the change of anteroposterior position and tibiofemoral rotational angles was also assessed. Results The intraoperative anteroposterior position change was −1.7 ± 3.4 mm (a positive value indicates tibial posterior shift). Flexion angle improvement was negatively correlated with intraoperative change of tibiofemoral anteroposterior position ( R 2  = 0.17, p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-019-05624-x