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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

07.07.2023 | Knee Arthroplasty

Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty

verfasst von: Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Susumu Takemura, Hiroaki Nakamura

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 11/2023

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Abstract

Introduction

It is preferable to reduce postoperative excessive rotational mismatch between the femur and tibia that causes poor clinical results following total knee arthroplasty (TKA). The aim of this study is to compare postoperative rotational mismatches and clinical outcomes with mobile- and fixed-bearing prostheses.

Materials and methods

This study classified 190 TKAs into two groups equally by propensity score matching: mobile-bearing group (n = 95) and fixed-bearing group (n = 95). Computed tomography images of the whole leg were taken at 2 weeks postoperatively. The component alignments, rotational mismatches between the femur and tibia, and rotations among components were measured three-dimensionally. The knee range of motion, New Knee Society Score (KSS) subjective sores, and Forgotten Joint Score (FJS-12) were assessed at the final follow-up.

Results

Rotational mismatch between the femur and tibia was significantly less in the mobile- (− 0.8° ± 7.3°) than in the fixed-bearing (3.3° ± 8.5°, p < 0.001) group. New KSS functional activity score was significantly poorer in patients with excessive rotational mismatch (61.3 ± 21.4) than in those without it (49.5 ± 20.6, p = 0.02). Comparing mobile-bearing prosthesis, the use of fixed-bearing prosthesis was a risk factor for postoperative excessive rotational mismatch (odds ratio: 2.32, p = 0.03).

Conclusion

When compared to a fixed-bearing prosthesis, TKA using a mobile-bearing prosthesis could suppress the postoperative rotational mismatch between the femur and tibia that causes poor subjective functional activity score. However, since this study was conducted for PS-TKA, the results might not be applicable to other models.

Ritter MA, Davis KE, Davis P et al (2013) Preoperative malalignment increases risk of failure after total knee arthroplasty. J Bone Joint Surg Am 95:126–131. https://doi.org/10.2106/JBJS.K.00607CrossRefPubMed

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 92:1238–1244. https://doi.org/10.1302/0301-620X.92B9.23516CrossRefPubMed

Verlinden C, Uvin P, Labey L et al (2010) The influence of malrotation of the femoral component in total knee replacement on the mechanics of patellofemoral contact during gait. J Bone Joint Surg Br 92:737–742. https://doi.org/10.1302/0301-620X.92B5.22603CrossRefPubMed

Panni AS, Ascione F, Rossini M et al (2018) Tibial internal rotation negatively affects clinical outcomes in total knee arthroplasty: a systematic review. Knee Surg Sport Traumatol Arthrosc 26:1636–1644. https://doi.org/10.1007/s00167-017-4823-0CrossRef

Ueyama H, Minoda Y, Sugama R et al (2020) Malrotation of the fixed-bearing posterior stabilized total knee prosthesis causes a postoperative rotational mismatch between the femur and tibia. Knee Surg Sport Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-05864-2CrossRef

Tjørnild M, Søballe K, Hansen PM et al (2015) Mobile- vs. fixed-bearing total knee replacement. Acta Orthop 86:208–214. https://doi.org/10.3109/17453674.2014.968476CrossRefPubMedPubMedCentral

Austin PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res 46:399–424. https://doi.org/10.1080/00273171.2011.568786CrossRefPubMedPubMedCentral

Ueyama H, Minoda Y, Sugama R et al (2019) Two-dimensional measurement misidentifies alignment outliers in total knee arthroplasty: a comparison of two- and three-dimensional measurements. Knee Surg Sport Traumatol Arthrosc 27:1497–1503. https://doi.org/10.1007/s00167-018-5175-0CrossRef

Berger RA, Rubash HE, Seel MJ et al (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-199301000-00008CrossRefPubMed

10.

Akagi M, Oh M, Nonaka T et al (2004) An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-200403000-00030CrossRefPubMed

11.

Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163. https://doi.org/10.1016/j.jcm.2016.02.012CrossRefPubMedPubMedCentral

12.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-198911000-00004CrossRefPubMed

13.

Scuderi GR, Bourne RB, Noble PC et al (2012) The new knee society knee scoring system. Clin Orthop Relat Res 470:3–19. https://doi.org/10.1007/s11999-011-2135-0CrossRefPubMed

14.

Behrend H, Giesinger K, Giesinger JM, Kuster MS (2012) The “forgotten joint” as the ultimate goal in joint arthroplasty. J Arthroplasty 27:430–436. https://doi.org/10.1016/j.arth.2011.06.035CrossRefPubMed

15.

Minoda Y, Iwaki H, Ikebuchi M et al (2012) The flexion gap preparation does not disturb the modified gap technique in posterior stabilized total knee arthroplasty. Knee 19:832–835. https://doi.org/10.1016/j.knee.2012.03.007CrossRefPubMed

16.

Ueyama H, Minoda Y, Sugama R et al (2019) An accelerometer-based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D measurements. Knee Surg Sport Traumatol Arthrosc 27:1580–1586. https://doi.org/10.1007/s00167-018-5082-4CrossRef

17.

Gøttsche D, Gromov K, Viborg PH et al (2019) Weight affects survival of primary total knee arthroplasty: study based on the Danish Knee Arthroplasty Register with 67,810 patients and a median follow-up time of 5 years. Acta Orthop 90:60–66. https://doi.org/10.1080/17453674.2018.1540091CrossRefPubMed

18.

Okamoto N, Nakamura E, Nishioka H et al (2014) In vivo kinematic comparison between mobile-bearing and fixed-bearing total knee arthroplasty during step-up activity. J Arthroplasty 29:2393–2396. https://doi.org/10.1016/j.arth.2014.02.022CrossRefPubMed

19.

Angibaud LD, Dai Y, Liebelt RA et al (2015) Evaluation of the accuracy and precision of a next generation computer-assisted surgical system. Clin Orthop Surg 7:225–233. https://doi.org/10.4055/cios.2015.7.2.225CrossRefPubMedPubMedCentral

20.

Kuriyama S, Hyakuna K, Inoue S et al (2014) Tibial rotational alignment was significantly improved by use of a CT-navigated control device in total knee arthroplasty. J Arthroplasty 29:2352–2356. https://doi.org/10.1016/j.arth.2014.06.016CrossRefPubMed

21.

Kawahara S, Okazaki K, Matsuda S et al (2014) Internal rotation of femoral component affects functional activities after TKA–survey with the 2011 Knee Society Score. J Arthroplasty 29:2319–2323. https://doi.org/10.1016/j.arth.2013.11.017CrossRefPubMed

22.

Jónasson G, Helgason A, Ingvarsson Þ et al (2016) The effect of tibial rotation on the contribution of medial and lateral hamstrings during isometric knee flexion. Sports Health 8:161–166. https://doi.org/10.1177/1941738115625039CrossRefPubMed

23.

Saç A, Taşmektepligil MY (2018) Correlation between the Q angle and the isokinetic knee strength and muscle activity. Turkish J Phys Med Rehabil 64:308–313. https://doi.org/10.5606/tftrd.2018.2366CrossRef

24.

Giesinger K, Hamilton DF, Jost B et al (2014) Comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthr Cartil 22:184–189. https://doi.org/10.1016/j.joca.2013.11.001CrossRef

25.

Joice MG, Bhowmick S, Amanatullah DF (2017) Perioperative physiotherapy in total knee arthroplasty. Orthopedics 40:e765–e773. https://doi.org/10.3928/01477447-20170518-03CrossRefPubMed

26.

Zeni JA, Snyder-Mackler L (2010) Early postoperative measures predict 1- and 2-year outcomes after unilateral total knee arthroplasty: importance of contralateral limb strength. Phys Ther 90:43–54. https://doi.org/10.2522/ptj.20090089CrossRefPubMedPubMedCentral

Titel: Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty
verfasst von: Hideki Ueyama
Yukihide Minoda
Ryo Sugama
Yoichi Ohta
Susumu Takemura
Hiroaki Nakamura
Publikationsdatum: 07.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 11/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04971-2

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Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty

Abstract

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Materials and methods

Results

Conclusion

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