Bone morphotypes of the varus and valgus knee

Thienpont, Emmanuel; Schwab, Pierre‐Emmanuel; Cornu, Olivier; Bellemans, Johan; Victor, Jan

doi:10.1007/s00402-017-2626-x

Cited by 122 publications

(87 citation statements)

References 35 publications

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“…Also, preoperative pain and functional status, as measured by PROs, have been shown to predict pain and functional ability after TKAs [12,13]. There are some reports focused on radiological factors of the knee, such as bone morphology, knee alignment and osteophytes, but they evaluate only the variation of radiographic factors themselves or the relationships between the factors and the progression of osteoarthritis [14][15][16][17][18]. Thus far, there is little information regarding the influence of preoperative radiological differences on PROs after TKA.…”

Section: Introductionmentioning

confidence: 99%

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Toguchi

Nakajima

Akatsu

et al. 2020

BMC Musculoskelet Disord

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Background: Total knee arthroplasty (TKA) is the major surgical treatment for end-stage osteoarthritis (OA). Despite its effectiveness, there are about 20% of patients who are dissatisfied with the outcome. Predicting the surgical outcome preoperatively could be beneficial in order to guide clinical decisions. Methods: One-hundred and ten knees of 110 consecutive patients who underwent TKAs for varus knees resulting from OA were included in this study. Preoperative varus deformities were evaluated by femorotibial angle (FTA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), and classified as a severe varus (SV) or a mild varus (MV) group. The osteophyte score (OS), which we developed originally, was also calculated based on the size of the osteophytes and classified as groups with more or less osteophytes. We compared preoperative and 1year postoperative range of motion, the Knee Society Score, and Japanese Knee injury Osteoarthritis Outcome Score (KOOS) between SV and MV groups (varus defined by FTA, MPTA, or LDFA), in each group with more or less osteophytes. Results: When varus deformities were defined by FTA, regardless of OS, postoperative KOOS subscales and/or the improvement rates were significantly higher in the SV group than in the MV group. When varus defined by MPTA, regardless of OS, there were no significant differences in postoperative KOOS subscales between groups. However, when varus defined by LDFA, scores for pain, activities of daily living (ADL), and quality of life (QOL) on postoperative KOOS and/or the improvement rates were significantly higher in the SV group than in the MV group only in patients with less osteophytes. No significant differences were found between groups in patients with more osteophytes. Conclusions: We classified OA types by radiographic measurements of femur and tibia in combination with OS. Postoperative patient-reported outcomes were better in patients with SV knees but were poor in patients with knees with MV deformity and less osteophytes.

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Section: Introductionmentioning

confidence: 99%

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Toguchi

Nakajima

Akatsu

et al. 2020

BMC Musculoskelet Disord

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“…Complicating this goal is that patients presenting with osteoarthritis often have either varus or valgus deformity. Significant deformities are more difficult to correct to neutral mechanical alignment if conventional instrumentation is used [ 37 , 38 ]. Depending on the degree of deformity, the surgical technique, and the choice of implant, the amount of necessary constraint might differ [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…The authors found that bone morphology in varus and valgus deformity is different before and after OA, and that perpendicular cuts to mechanical axes do not necessarily lead to a neutral mechanical axis. Deformities over 10° usually had an extra-articular component, thus correction to neutral alignment with conventional instruments might not be sufficient to compensate for femoral bowing or extra-articular deformity [ 38 ]. The JOURNEY™ II BCS provides more mobility in the lateral compartment than other total knee systems provide, to replicate normal knee kinematics.…”

Section: Discussionmentioning

confidence: 99%

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Christen¹,

Kopjar

2018

Arch Orthop Trauma Surg

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IntroductionTotal knee arthroplasty (TKA) can provide pain relief and good long-term results. However, nearly 30% of post-surgical patients are unsatisfied due to persistent pain and functional deficits. A second-generation bi-cruciate stabilized TKA device has a post-cam mechanism with an asymmetric femoral component, a polyethylene insert, and a medially concave and laterally convex shape. The device is designed to provide guided motion, and thus improve knee kinematics by more closely approximating a normal knee. The aim of this study was to evaluate early complication and revision rates of the second-generation device and to compare its clinical performance to the first-generation device.Materials and methodsIn this retrospective, longitudinal, non-concurrent cohort study, 140 TKAs were performed using the second-generation device on 131 patients from 2012 to 2016, and 155 TKAs were performed using the first-generation device on 138 patients from 2009 to 2012. Primary outcomes were occurrence of revisions and reoperations.ResultsThere were 31 reoperations [3.21 per 100 observed component years (OCY)] in 22 (2.28 per 100 OCY) TKAs in the first-generation device cohort compared to five reoperations (1.92 per 100 OCY) in four TKAs (1.54 per 100 OCY) in the second-generation device cohort. The adjusted hazard ratio (HR) was 3.50 (P = 0.0254). There were 21 revisions (2.17 per 100 OCY) in 16 (1.66 per 100 OCY) TKAs in the first-generation device cohort, compared to only three revisions (1.15 per 100 OCY) in two TKAs (0.77 per 100 OCY) in the second-generation device cohort. The adjusted HR was 4.16 (P = 0.0693).ConclusionThe improved design of the second-generation device appears to be associated with a lower risk of reoperation and revision compared to that of the first-generation device.Level of evidenceIII.

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“…Preoperative demographic data and clinical information were collected, including age, sex, body mass index (BMI), side of the operation, Charlson Comorbidity Index (CCI), use of walking assisting device, preoperative alignment, range of motion (ROM), and modified knee score. Alignment of the knee was determined using hip knee axis (HKA), and alignment was classified as varus alignment if the HKA was <178 o , and valgus alignment if the HKA was >182 o [ 13 ]. Our primary outcome of interest was the performance-based tests: Timed Up and Go (TUG) test and 2-min walk test (2MWT).…”

Section: Methodsmentioning

confidence: 99%

Midterm functional recovery of Total knee arthroplasty patients compared between the ATTUNE knee system and the press fit condylar (PFC) SIGMA knee system

Vanitcharoenkul

Unnanuntana

2021

BMC Musculoskelet Disord

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Background The ATTUNE Knee System is a new prosthetic design that has theoretical advantages over the Press Fit Condylar (PFC) Sigma Knee System specific to improved knee kinematics and patellofemoral joint tracking. This study aimed to evaluate functional outcomes compared between the ATTUNE and PFC Sigma designs at a minimum follow-up of 5 years. Methods We retrospectively reviewed data from total knee arthroplasty (TKA) patients who received either the ATTUNE or PFC Sigma system during November 2013 to February 2015 at Siriraj Hospital (Bangkok, Thailand). Functional outcomes were evaluated using Timed Up and Go (TUG) test, 2-min walk test (2MWT), modified knee score, numerical rating scale-pain, range of motion (ROM), and rate of anterior knee pain and crepitation at preoperation, 3-months, 1-year, and 5-years postoperatively. Results Of 113 patients, 59 and 54 received the PFC Sigma and ATTUNE systems, respectively. At a minimum of 5-years follow-up, all functional outcomes improved significantly from the preoperative period although TUG test and 2MWT declined significantly from 1- to 5-years postoperatively only in the PFC Sigma group. The mean ROM at 5-years postoperatively was significantly higher in ATTUNE than in PFC Sigma; however, the difference was small (116° vs. 110°, respectively; p = 0.041). There were no significant differences in any of the other outcome measurements, including anterior knee pain, clunking, and crepitation, between groups at any study time point. Conclusions Our results revealed no major differences in functional outcomes between the PFC Sigma and ATTUNE TKA designs at an intermediate-term follow-up of at least 5 years. Longer-term follow-up study is needed to evaluate the benefits of the ATTUNE design relative to polyethylene wear and the rate of aseptic loosening.

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Bone morphotypes of the varus and valgus knee

Abstract: Level IV study.

Cited by 122 publications

References 35 publications

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Midterm functional recovery of Total knee arthroplasty patients compared between the ATTUNE knee system and the press fit condylar (PFC) SIGMA knee system

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