Kinematic alignment in total knee arthroplasty leads to a better restoration of patellar kinematics compared to mechanic alignment
Tóm tắt
The influence of different implantation techniques in TKA on tibiofemoral kinematics was analysed in few investigations so far. However, the influence on patellar kinematics remain unclear. The aim of the present investigation was to compare patellar kinematics of the natural knee with those of knees after both kinematically and mechanically aligned TKAs. Patellar kinematics of ten cadaveric knees before and after TKAs implanted using both a kinematic and mechanic alignment technique were investigated and compared using a commercial optical computer navigation system. There was a statistically significant difference between natural patellar kinematics and both implantation techniques analysing mediolateral shift. Patellar lateral tilt showed significant better results in the kinematically compared to the mechanically aligned TKAs. In terms of patella rotation, the patella of both mechanically and kinematically aligned TKAs showed significant higher values for external rotation compared to the natural knee. Regarding epicondylar distance again a significant better restoration of natural kinematics could be found in the kinematically aligned TKAs. Kinematically aligned TKAs showed a better overall restoration of patellar kinematics compared to a conventional mechanical alignment technique. In terms of clinical usefulness, the present study highlights the potential benefit for clinical outcome using a kinematically aligned implantation technique in TKA to achieve a better restoration of natural patellofemoral kinematics.
Tài liệu tham khảo
Akagi M, Oh M, Nonaka T, Tsujimoto H, Asano T, Hamanishi C (2004) An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res 420:213–219
Barrack RL, Schrader T, Bertot AJ et al (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res 392:46–55
Belvedere C, Catani F, Ensini A et al (2007) Patellar tracking during total knee arthroplasty: an in vitro feasibility study. Knee Surg Sports Traumatol Arthrosc 15:985–993
Brar AS, Howell SM, Hull ML, Mahfouz MR (2016) Does kinematic alignment and flexion of a femoral component designed for mechanical alignment reduce the proximal and lateral reach of the trochlea? J Arthroplast 31(8):1808–1813
Clary CW, Fitzpatrick CK, Maletsky LP, Rullkoetter PJ (2013) The influence of total knee arthroplasty geometry on mid-flexion stability: an experimental and finite element study. J Biomech 46(7):1351–1357
Grood SE, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application for the knee. J Biomech Eng 105:136–144
Ishikawa M, Kuriyama S, Ito H, Furu M, Nakamura S, Matsuda S (2015) Kinematic alignment produces near-normal knee motion but increases contact stress after total knee arthroplasty: a case study on a single implant design. Knee 22(3):206–212
Keshmiri A, Maderbacher G, Baier C, Zeman F, Grifka J, Springorum HR (2016) Significant influence of rotational limb alignment parameters on patellar kinematics: an in vitro study. Knee Surg Sports Traumatol Arthrosc 24(8):2407–2414
Keshmiri A, Springorum HR, Baier C, Zeman F, Grifka J, Maderbacher G (2016) Changes in sagittal component alignment alters patellar kinematics in TKA: an in vitro study. Knee Surg Sports Traumatol Arthrosc 24(3):823–829
Masri BA, McCormack RG (1995) The effect of knee flexion and quadriceps contraction on the axial view of the patella. Clin J Sport Med 5(1):9–17
Nicoll D, Rowley DI (2010) Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg Br 92-B:1238–1244
Outerbridge Re (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43-B:752–757
Pejhan S, Bohm E, Brandt JM, Wyss U (2017) The influence of geometric design variables on the kinematic performance of a surface-guided total knee replacement. J Orthop Surg (Hong Kong) 25(3):2309499017727922
Rivière C, Iranpour F, Harris S, Auvinet E, Aframian A, Parratte S, Cobb J (2018) Differences in trochlear parameters between native and prosthetic kinematically or mechanically aligned knees. Orthop Traumatol Surg Res 104(2):165–170
Slevin O, Schmid FA, Schiapparelli FF, Rasch H, Amsler F, Hirschmann MT (2017) Coronal femoral TKA position significantly influences in vivo patellar loading in unresurfaced patellae after primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25(11):3605–3610
Takahashi T, Ansari J, Pandit HG (2018) Kinematically aligned total knee arthroplasty or mechanically aligned total knee arthroplasty. J Knee Surg 31:999–1006
Wang H, Simpson KJ, Chamnongkich S, Kinsey T, Mahoney OM (2008) Biomechanical influence of TKA designs with varying radii on bilateral TKA patients during sit-to-stand. Dyn Med 13(7):12
Werth L, Saffarini M, Amsler F, Abdelkafy A, Hirschmann MT (2017) The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25(12):3818–3823
Xie X, Rusly R, DesJardins JD, Voss F, Chillag K, LaBerge M (2017) Effect of rotational prosthetic alignment variation on tibiofemoral contact pressure distribution and joint kinematics in total knee replacement. Proc Inst Mech Eng Part H 231(11):1034–1047
Zeller IM, Sharma A, Kurtz WB, Anderle MR, Komistek RD (2017) Customized versus patient-sized cruciate-retaining total knee arthroplasty: an in vivo kinematics study using mobile fluoroscopy. J Arthroplast 32(4):1344–1350
Zhang LK, Wang XM, Niu YZ, Liu HX, Wang F (2016) Relationship between patellar tracking and the “screw-home” mechanism of tibiofemoral joint. Orthop Surg 8(4):490–495