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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, 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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Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
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
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
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
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, UNITED STATES Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos-Gomez, MD, PhD, SPAIN
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, 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
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, MBBS, FRACS, FAOrthA, AUSTRALIA
Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study ePoster Presentation Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS, INDIA
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, MD, PhD, JAPAN Takanori Iriuchisima, MD, JAPAN
Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Deepak Gupta, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
A Prospective Randomised Study to Compare the Clinical and Radiological Outcomes of Functionally Aligned versus Mechanically Aligned Total Knee Arthroplasty with Robotic Arm Assistance ePoster Presentation Jai Thilak, MS, MCh, FRCS, INDIA Amal Antony Paul, MBBS, INDIA
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES

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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