Changes in anteroposterior stability and proprioception after different types of knee arthroplasty

Wautier, Delphine; Thienpont, Emmanuel

doi:10.1007/s00167-016-4038-9

Cited by 35 publications

(37 citation statements)

References 47 publications

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“…In addition, BCR TKA knees did not demonstrate increased anteroposterior laxity when compared with the contralateral non‐operated knee ( p = 0.957), consistent with the findings of Camilla et al, using the same BCR TKA implant in a recent in‐vitro study . This finding supports the importance of ACL preservation in restoring anteroposterior stability in previous in‐vitro, in‐vivo, and clinical unicompartmental knee arthroplasty studies . The clinical laxity test may provide a suitable surrogate test for in‐vivo ACL elongation and serve as a potential patient screening tool for consideration of BCR TKA implants.…”

Section: Discussionsupporting

confidence: 86%

In‐vivo elongation of anterior and posterior cruciate ligament in bi‐cruciate retaining total knee arthroplasty

Tsai

Liow

Peng

et al. 2018

Journal Orthopaedic Research

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Anterior and posterior cruciate ligament (ACL and PCL) sacrifice in contemporary total knee arthroplasty (TKA) has been considered a potential factor leading to abnormal knee kinematics. Bi-cruciate retaining (BCR) TKA design allows retention of both ACL and PCL. However, there is a limited data on the ACL/PCL in-vivo elongation characteristics of BCR TKA. The study aimed to evaluate and compare the in-vivo elongation patterns of ACL/PCL between BCR TKA and contralateral non-implanted knee and to explore potential factors leading to the changed elongation patterns between limbs. ACL/PCL elongations of both knees during sit-to-stand were measured in 29 unilateral BCR TKA patients using a validated dual fluoroscopic tracking technique. Joint gap changes of the BCR TKA knees relative to the contralateral knee were quantified. BCR TKA and the contralateral non-implanted knee exhibited similar ACL elongation at extension and clinical anterior knee laxity. However, BCR TKA showed significantly greater PCL elongation during flexion than the non-implanted knee. Variation of changed elongation was observed for both ACL and PCL, suggesting a heterogeneous restoration of normal ACL/PCL functions. A significant correlation was found between extension joint gap change and the change of ACL elongation, highlighting the importance of precise joint line restoration and soft tissue balancing during BCR TKA surgery. Our findings suggest that BCR TKA did not fully restore "near-normal" cruciate ligament elongation patterns and anteroposterior stability. Considerable heterogeneity remains in the retained ligament elongation patterns and warrants further investigations of multifactorial factors to optimize ACL/PCL functions in BCR TKA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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Section: Discussionsupporting

confidence: 86%

In‐vivo elongation of anterior and posterior cruciate ligament in bi‐cruciate retaining total knee arthroplasty

Tsai

Liow

Peng

et al. 2018

Journal Orthopaedic Research

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“…22,[32][33][34] Wautier and Thienpont compared anteroposterior translation in groups of 10 patients, each with a different type of arthroplasty, including an MS design, two PS designs, and a unicompartmental arthroplasty (UKA) design. 23 They found that the MS design had sagittal plane laxity similar to the UKA, whereas the PS designs had increased laxity at both 30-and 90-degree of knee flexion. They found no differences in patient-reported outcomes including the Knee Society Score and the Forgotten Joint Score.…”

Section: Discussionmentioning

confidence: 97%

“…21,22 Thirty pounds of anterior translation force was applied to the tibia and the anterior displacement was measured in millimeters, as has been previously described. [21][22][23][24][25] The KT-1000 leg positioners were used, and a goniometer was used to confirm appropriate knee flexion prior to testing. Total relaxation of the limb was reinforced throughout the duration of testing, and measurements were repeated until identical measurements (AE0.5 mm) were obtained on three consecutive trials.…”

Section: Methodsmentioning

confidence: 99%

“…A power analysis with a standardized difference of 0.8, a power of 80%, and an α of 0.05 yielded a required sample size for the detection of a difference in KT-1000 measurements at 90-degree knee flexion of 24 patients per group. 23,26 Descriptive statistics were calculated for patient characteristics, patient-reported outcomes, and results of KT-1000 testing. The Shapiro-Wilk test was used to identify whether each continuous variable fit a normal distribution.…”

Section: Methodsmentioning

confidence: 99%

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The Effect of Implant Design on Sagittal Plane Stability: A Randomized Trial of Medial- versus Posterior-Stabilized Total Knee Arthroplasty

et al. 2019

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Up to 20% of total knee arthroplasty (TKA) patients report dissatisfaction with their outcome, especially with weight-bearing in flexion (WBiF) activities. Sagittal plane instability may contribute to dissatisfaction following TKA. We assessed the impact of implant design on TKA sagittal plane stability and clinical satisfaction. We randomized patients to receive one of two TKA implant designs: medial-stabilized (MS) or posterior-stabilized (PS). Sagittal stability was assessed using a KT-1000 arthrometer. Patient-reported outcome measures, including a custom bank of questions targeting patient satisfaction (0–100%) with WBiF activities, were administered to patients 2 years following surgery. The final analysis included 50 patients (25 MS, 25 PS). The MS group had greater sagittal plane stability than the PS group at 30-degree flexion (5.6 ± 1.9 vs. 10.2 ± 2.7 mm; p < 0.0001) but not at 90-degree flexion (4.1 ± 2 vs. 5.3 ± 3 mm; p = 0.14). Range of motion was not different (111.3 ± 10.4 vs. 114.7 ± 10.7 degrees; p = 0.31). There were no differences in the PROMIS (Patient-Reported Outcomes Measurement Information System) score, Oxford Knee Score, Knee Society Score, Forgotten Joint Score, or Veterans Rand. The MS group had no difference in satisfaction for WBiF activities versus non-WBiF activities (80.5 ± 18 vs. 88.3% ± 16.4%; p = 0.13), whereas the PS group had significantly worse satisfaction for WBiF versus non-WBiF activities (71.6 ± 24.6 vs. 87.8% ± 16.6%; p = 0.019). An MS prosthetic design was more stable in the sagittal plane in midflexion compared with a PS design. There was no difference in patient-reported outcomes, although custom survey data suggest improved satisfaction with MS design during WBiF activities.

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“…Hypermobility, i.e., excessive anterior-posterior (A-P) displacement (Fantozzi et al, 2006;Stoddard et al, 2013) and/or internal-external (I-E) rotation (Wautier and Thienpont, 2017;Zaffagnini et al, 2014) is a familiar manifest of the unbounded kinematic response of an unstable knee. Yet, whether the diagnosis of instability should be excluded when hypermobility is not observed during clinical assessments is a matter of debate (Martín-Hernández et al, 2014;Nakahara et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Computational analysis of knee joint stability following total knee arthroplasty

Ardestani

Chen

Noori-Dokht

et al. 2019

Journal of Biomechanics

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The overall objective of this study was to introduce knee joint power as a potential measure to investigate knee joint stability following total knee arthroplasty (TKA). Specific aims were to investigate whether weakened knee joint stabilizers cause abnormal kinematics and how it influences the knee joint kinetic (i.e., power) in response to perturbation. Patient-specific musculoskeletal models were simulated with experimental gait data from six TKA patients (baseline models). Muscle strength and ligament force parameter were reduced by up to 30% to simulate weak knee joint stabilizers (weak models). Two different muscle recruitment criteria were tested to examine whether altered muscle recruitment pattern can mask the influence of weakened stabilizers on the knee joint kinematics and kinetics. Level-walking knee joint kinematics and kinetics were calculated though force-dependent kinematic and inverse dynamic analyses. Bode analysis was then recruited to estimate the knee joint power in response to a simulated perturbation. Weak models resulted in larger anterior-posterior (A-P) displacement and internal-external (I-E) rotation compared to baseline (I-E: 18.4±8.5 vs. 11.6±5.7 (deg), A-P: 9.7±5.6 vs. 5.5±4.1 (mm)). Changes in muscle recruitment criterion however altered the results such that A-P and I-E were not notably different from baseline models. In response to the simulated perturbation, weak models versus baseline models generated a delayed power response with unbounded magnitudes. Perturbed power behavior of the knee remained unaltered regardless of the muscle recruitment criteria. In conclusion, impairment at the knee joint stabilizers may or may not lead to excessive joint motions but it notably affects the knee joint power in response to a perturbation. Whether perturbed knee joint power is associated with the patient-reported outcome requires further investigation.

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Changes in anteroposterior stability and proprioception after different types of knee arthroplasty

Abstract: II.

Cited by 35 publications

References 47 publications

In‐vivo elongation of anterior and posterior cruciate ligament in bi‐cruciate retaining total knee arthroplasty

In‐vivo elongation of anterior and posterior cruciate ligament in bi‐cruciate retaining total knee arthroplasty

The Effect of Implant Design on Sagittal Plane Stability: A Randomized Trial of Medial- versus Posterior-Stabilized Total Knee Arthroplasty

Computational analysis of knee joint stability following total knee arthroplasty

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