Bicruciate-retaining total knee arthroplasty reproduces in vivo kinematics of normal knees to a lower extent than unicompartmental knee arthroplasty

Kono, Kenichi; Inui, Hiroshi; Tomita, Tadanori; Yamazaki, Takao; Taketomi, Shuji; Tanaka, Sakae

doi:10.1007/s00167-019-05754-2

Cited by 29 publications

(30 citation statements)

References 40 publications

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“…These kinematic changes were not fully restored after traditional ACL-sacrificing surgery 3 . While BCR designs have been developed to retain the ACL, BCR-TKA also does not restore normal knee kinematics 13,19,20 . Our previous study demonstrated that knees after BCR-TKA with an anatomical articular surface showed lower femoral external rotation and lateral posterior translation with flexion than normal knees during squatting 19 .…”

Section: Discussionmentioning

confidence: 99%

“…While BCR designs have been developed to retain the ACL, BCR-TKA also does not restore normal knee kinematics 13,19,20 . Our previous study demonstrated that knees after BCR-TKA with an anatomical articular surface showed lower femoral external rotation and lateral posterior translation with flexion than normal knees during squatting 19 . Normal knees during squatting displayed large femoral external rotation at early-flexion called screw-home movement 21,22 , and medial-pivot motion followed by femoral rollback 22 .…”

Section: Discussionmentioning

confidence: 99%

“…In BCR-TKA knees, extraction of the bony contour creation was difficult because of metal artefact in the CT scans. Thus, 2D/3D registration of femoral and tibial implants was performed initially; subsequently 2D/3D registration of femoral and tibial bone models was performed as previously reported 19 . The relative position between the implant and the bone was matched using surface registration between preoperative 3D bone models and 3D implant and bone models www.nature.com/scientificreports/ created from postoperative CTs (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Femoral rotation and varus-valgus angle relative to the tibia, anteroposterior (AP) translation of the medial sulcus (medial side), and lateral epicondyle (lateral side) of the femur on the plane perpendicular to the tibial mechanical axis in each flexion angle were evaluated 22 . AP translation was calculated as a percentage relative to the proximal AP dimension of the tibia 19,22 . External rotation was denoted as positive; internal rotation as negative.…”

Section: Methodsmentioning

confidence: 99%

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In vivo kinematics and cruciate ligament forces in bicruciate-retaining total knee arthroplasty

Kono

Inui

Tomita

et al. 2021

Sci Rep

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We analyzed the effects of bicruciate-retaining total knee arthroplasty (BCR-TKA) on knee kinematics and cruciate ligament forces. Patients (N = 15) with osteoarthritis (OA) and an intact anterior cruciate ligament (ACL) underwent magnetic resonance imaging and single-plane fluoroscopy to measure tibiofemoral kinematics during two deep knee bend activities before and after BCR-TKA: (1) weight-bearing squat; (2) non-weight-bearing cross-legged sitting. Forces in ligament bundles were calculated using VivoSim. The dynamic range of varus-valgus angulation decreased from 3.9 ± 4.4° preoperatively to 2.2 ± 2.7° postoperatively. Preoperatively, the medial femoral condyle translated anteriorly from 10° to 50° of flexion, and posteriorly beyond 50° of flexion. Postoperatively, the medial and lateral femoral condyles translated posteriorly throughout flexion in a medial pivot pattern. ACL forces were high in extension and decreased with flexion pre- and postoperatively. PCL forces increased with flexion preoperatively and did not change significantly postoperatively. Preoperatively, ACL forces correlated with anteroposterior translation of the femoral condyles. Postoperatively, PCL forces correlated with anteroposterior translation of the lateral femoral condyle. BCR-TKA altered knee kinematics during high flexion activity which correlated significantly with changes in cruciate ligament forces.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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In vivo kinematics and cruciate ligament forces in bicruciate-retaining total knee arthroplasty

Kono

Inui

Tomita

et al. 2021

Sci Rep

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“…Kono et al. 16 reported that BCR TKA induced medial pivot motion similar to that of a normal knee in the preoperative group as well as in the preoperative group due to the anterior and posterior cruciate ligaments. It is possible that the same kinematics were reproduced in the present study, which allowed the patients to walk 6 weeks after surgery.…”

Section: Discussionmentioning

confidence: 96%

Anatomical bi-cruciate retaining TKA improves gait ability earlier than bi-cruciate stabilized TKA based on triaxial accelerometery data: A prospective cohort study

Amemiya

Kaneko

Omata

et al. 2021

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Background Total knee arthroplasty (TKA) is a common and cost-effective surgical treatment for osteoarthritis of the knee. However, only 82-89% of patients who performed TKA are satisfied with the postoperative outcomes. Therefore, bi-cruciate retaining (BCR) TKA is re-attracting attention. By retaining the anterior cruciate ligament (ACL), the knee may obtain the kinematic pathway that are closer to the native knee. The aim of the present study is to compare the ability to walk before and after surgery in patients who underwent bi-cruciate retaining total knee arthroplasty (BCR TKA) versus bi-cruciate stabilized (BCS) TKA during the early postoperative period. Methods Subjects included patients who underwent BCR TKA (10 knees) and BCS TKA (15 knees). We administered 10-meter gait tests before surgery and at 6 weeks and 3 months after surgery. We collected the following triaxial accelerometery data with a portable gait analyzer: walking time, number of steps, velocity, stride length, and coefficient of variability (CV) of double-leg support time while walking. Results Patients who underwent BCR TKA improved their gait ability [walking time ( p < 0.01), number of steps ( p < 0.05), velocity ( p < 0.01), and stride length ( p < 0.01) more than those who received BCS TKA at 6 weeks after surgery. BCR TKA improved gait ability (walking time, number of steps, velocity, and stride length) more than BCS TKA at 6 weeks after surgery. At 6 weeks after surgery, CV of double-leg support time while walking improved more in the BCR TKA group than in the BCS TKA group ( p < 0.05). Conclusions BCR TKA is associated with improved gait ability in the early postoperative period.

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Anterior cruciate ligament‐deficient knee induces a posterior location of the femur in the medial compartment during squatting

Kage

Taketomi

Tomita

et al. 2022

Journal Orthopaedic Research

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Although an anterior cruciate ligament (ACL) deficiency induces knee osteoarthritis, particularly in the medial compartment, the kinematics remains partially unclear. This study investigated the in vivo knee kinematics of ACL-deficient and normal knees by comparing them during squatting. This prospective comparative study included 17 ACL-deficient knees and 20 normal knees. The kinematics was investigated under fluoroscopy using a two-to three-dimensional registration technique. The anteroposterior (AP) translation of the medial and lateral sides of the femur, axial rotation of the femur relative to the tibia, and kinematic pathways were evaluated and compared. At first, the medial AP position of the femur translated anteriorly from 0°to midflexion, afterward it translated posteriorly in both ACL-deficient and normal knees. However, the medial AP position of the femur in the ACL-deficient knees was located significantly posteriorly compared with normal knees at 0-110°f lexion. The lateral AP position of the femur translated posteriorly from 0°to 150°f lexion in both ACL-deficient and normal knees. The lateral AP position of the femur in the ACL-deficient knees was located significantly posteriorly compared with that in normal knees at 0-10°flexion. The femur showed external rotation from 0°to 150°flexion in both ACL-deficient and normal knees. A medial pivot motion and subsequent bicondylar rollback were observed in both knees in the kinematic pathway. In conclusion, the AP position of the femur relative to the tibia was altered due to ACL deficiency, particularly in the medial compartment.

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Bicruciate-retaining total knee arthroplasty reproduces in vivo kinematics of normal knees to a lower extent than unicompartmental knee arthroplasty

Cited by 29 publications

References 40 publications

In vivo kinematics and cruciate ligament forces in bicruciate-retaining total knee arthroplasty

In vivo kinematics and cruciate ligament forces in bicruciate-retaining total knee arthroplasty

Anatomical bi-cruciate retaining TKA improves gait ability earlier than bi-cruciate stabilized TKA based on triaxial accelerometery data: A prospective cohort study

Anterior cruciate ligament‐deficient knee induces a posterior location of the femur in the medial compartment during squatting

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