Influence of posterior condylar offset on knee flexion after cruciate-sacrificing mobile-bearing total knee replacement: A prospective analysis of 410 consecutive cases

Bauer, Thomas W.; Biau, David; Colmar, M.; Poux, X.; Hardy, P.; Lortat-Jacob, A

doi:10.1016/j.knee.2009.11.001

Cited by 71 publications

(58 citation statements)

References 49 publications

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“…It is also worthy of note that PCO increase had a marginally significant correlation with worse WOMAC function score (CC=-0.03, p=0,054). Our findings of no correlation between PCO alteration and outcome scales in the knees replaced with PS prosthesis corroborate the previous studies reporting no effect of PCO alterations on maximum flexion in knees replaced with FB-PS prosthesis [1,20,32] or with MB-PS prosthesis [3,14,17]. These findings are also intuitively explainable by the fact that the kinematics in knees replaced with PS prosthesis are more profoundly dictated by the post-cam mechanism, which may minimize the kinematic effects of PCO alterations.…”

Section: Discussionsupporting

confidence: 90%

“…Several subsequent studies echoed the proposed correlation between PCO alteration and maximum flexion in knees replaced with CR prosthesis [1,23,24]. In contrast, other studies found no correlation in knees with MB-CR prosthesis [17,29], with FB-PS prosthesis [1,20,32], and with MB-PS prosthesis [3,14,17]. Our findings agree with these latter studies denying the correlation between PCO alteration and maximum flexion.…”

Section: Discussionsupporting

confidence: 90%

“…Several studies reported a definite correlation between PCO alteration and maximal flexion in CR knees [1,5,23,24], whereas two recently published studies did not find this association in MB-CR knees [17,29]. This association was not found in several studies involving PS prosthesis [1,3,14,17]. In addition, other studies reported that flexion kinematics and thus the ultimate flexion achieved differ between CR and PS TKAs [2,8,13,31].…”

Section: Introductionmentioning

confidence: 95%

“…Various factors, including maximal postoperative flexion, are thought to influence the functional outcomes of TKA [15,28]. After Bellemans et al [5] reported that alterations in posterior condylar offset (PCO) influences the maximal flexion achieved after TKA, numerous studies have evaluated the effect of these alterations [1,3,11,14,17,20,23,24,29]. However, these studies reported contradictory results regarding the effect of PCO on maximal postoperative flexion.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Posterior Condylar Offset on Maximal Flexion and Outcome Scales Following TKA in Asian Patients

Kwon

Jain²,

Kang³

et al. 2015

JISRF

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Background: Infection complicates traditional joint reconstruction prostheses in up to 7% of cases, witBackground: Alteration in femoral posterior condylar offset (PCO) after total knee arthroplasty (TKA) has been reported to influence maximal flexion angle after TKA. However, there are contradictory reports about its influence on clinical outcome, and the effects of PCO alterations may vary with implant type.Question / purposes: The purpose of this study was to determine whether PCO alterations affect maximal flexion after TKA and other functional outcomes, and whether the effects of PCO alterations differ by implant type.Patients and Methods: Fifty consecutive cases of TKAs in each of four implant types, namely, fixed bearing (FB) cruciate retaining (CR) or posterior stabilized (PS), mobile bearing (MB) CR or PS were included in the study. Patients were evaluated for maximal flexion and clinical outcome scales. The PCO alteration was measured using pre-and postoperative true lateral knee radiographs. Correlations between PCO alterations and functional outcomes including maximal flexion were compared among the four implant types.Results: No significant correlation was found between PCO alterations and maximal flexion achieved in any of the four implant groups (Correlation Coefficient [CC]=-0.03, 0.14, -0.14, 0.04; p> 0.05). The mean maximal postoperative flexion was greater in PS implants than in CR implants (p <0.05). In MB-CR implanted knees, a greater PCO alteration was correlated with worse anterior knee pain score as measured by the PF scoring system (CC=-0.44, p=0.003) and worse WOMAC pain score (CC=-0.41, p=0.007).Conclusions: Our findings indicate that PCO alterations have no effect on maximal postoperative flexion after TKA regardless of the implant type. Whether the implant is of PS or CR type is a better predictor of the final flexion achieved. However, increased PCO is correlated with worse pain score in MB-CR implants.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Influence of Posterior Condylar Offset on Maximal Flexion and Outcome Scales Following TKA in Asian Patients

Kwon

Jain²,

Kang³

et al. 2015

JISRF

View full text Add to dashboard Cite

show abstract

“…The total PCO is a combination of the bony condyles and the PCC thickness; PCO affects available knee flexion in TKA. 9,10 Most anatomic studies are conducted in arthritic individuals in whom cartilage and even bony erosion have taken place, and measurement is usually made by radiography and computed tomography that may underestimate normal PCO. [9][10][11][12][13] Our results suggested that pre-TKA templating may underestimate the normal PCO by approximately 2 mm, due to the cartilage.…”

Section: Discussionmentioning

confidence: 99%

Posterior Condylar Cartilage Thickness and Posterior Condylar Offset of the Femur: A Magnetic Resonance Imaging Study

Wernecke

Seeto

Chen

et al. 2016

J Orthop Surg (Hong Kong)

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Purpose. To measure the femoral posterior condylar cartilage (PCC) thickness and the posterior condylar offset (PCO) and determine the correlation between the 2 parameters in 530 normal subjects using magnetic resonance imaging (MRI Posterior condylar cartilage thickness and posterior condylar offset of the femur: a magnetic resonance imaging study Conclusion. Femoral PCC thickness was comparable in the medial and lateral sides. Males had thicker PCC in the medial and lateral sides than females.

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Relative contributions of design, alignment, and loading variability in knee replacement mechanics

Fitzpatrick

Clary

Laz

et al. 2012

Journal Orthopaedic Research

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Substantial variation in total knee replacement (TKR) outcomes exists within the patient population. Some of this variability is due to differences in the design of the implanted components and variation in surgical alignment, while other variability is due to differences in the applied forces and torques due to anatomic and physiological differences within a patient population. We evaluated the relative contributions of implant design, surgical alignment, and patient-specific loading variability to overall tibiofemoral joint mechanics to provide insight into which measures can be influenced through design and surgical decisions, and which are inherently dependent on variation within the patient population and should be considered in the robustness of the implant design and surgical procedure. Design, surgical, and loading parameters were assessed using probabilistic finite element methods during simulated stance-phase gait and squat activities. Patient-specific loading was found to be the primary contributor to joint loading and kinematics during low flexion, particularly under conditions of high external loads (for instance, the gait cycle with high internal-external torque), while design and surgical factors, particularly femoral posterior radius and posterior slope of the tibial insert became increasingly important in TKR performance in deeper flexion. ß

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Influence of posterior condylar offset on knee flexion after cruciate-sacrificing mobile-bearing total knee replacement: A prospective analysis of 410 consecutive cases

Cited by 71 publications

References 49 publications

Influence of Posterior Condylar Offset on Maximal Flexion and Outcome Scales Following TKA in Asian Patients

Influence of Posterior Condylar Offset on Maximal Flexion and Outcome Scales Following TKA in Asian Patients

Posterior Condylar Cartilage Thickness and Posterior Condylar Offset of the Femur: A Magnetic Resonance Imaging Study

Relative contributions of design, alignment, and loading variability in knee replacement mechanics

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