Joint kinematics following bi-compartmental knee replacement during daily life motor tasks

Leffler, Jorg; Scheys, Lennart; Planté-Bordeneuve, Thomas; Callewaert, B; Labey, Luc; Bellemans, Johan; Franz, Axel R.

doi:10.1016/j.gaitpost.2012.04.008

Cited by 38 publications

(30 citation statements)

References 30 publications

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“…Retention of both cruciate ligaments theoretically preserves proprioception, and maintains native knee kinematics. Several recent biomechanical studies have demonstrated this principle in BKA, showing improvement in 3-dimensional joint kinematics and gait analysis, which is comparable with healthy controls [8] , [9] . However, it is still unclear if these theoretical and biomechanical advantages will translate into significant clinical differences.…”

Section: Introductionsupporting

confidence: 52%

Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis

2017

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BackgroundInterest in bicompartmental knee arthroplasty (BKA) for the treatment of medial patellofemoral osteoarthritis (MPFOA) has grown in recent years because BKA offers a bone and ligament-preserving alternative to total knee arthroplasty (TKA). BKA only resurfaces the diseased compartments, while preserving proprioception and native knee kinematics. Therefore, the objective of this study is to assess knee function, perioperative morbidity, and implant survivability in patients undergoing BKA vs TKA for MPFOA.MethodsThe databases MEDLINE, PUBMED, and EMBASE were systematically searched. Randomized controlled trials and nonrandomized comparative studies comparing BKA with TKA for the treatment of MPFOA were included for further analysis. The primary outcome of interest was knee function. Secondary outcomes included range of movement, operation length, intraoperative blood loss, hospital length of stay, postoperative complications, and rate of revision length. The quality of evidence was evaluated using the GRADE approach. Meta-analysis was performed by pooling the results of the selected studies when possible.ResultsSix studies were selected for inclusion (4 prospective studies and 2 retrospective cohort studies). In total, 274 patients and 277 knees were included for analysis. There were no significant differences between the 2 groups at any time points in terms of knee function, length of stay, complication rate, or revision rate, when monolithic BKA designs were controlled for. BKA did result in significantly decreased intraoperative blood loss, at the expense of increased operative length compared with TKA.ConclusionsThe use of modular BKA for MPFOA is comparable with TKA in terms of short-term function, complication rate, and revision rate. BKA reduces intraoperative blood losses, but it is also more technically demanding, resulting in increased operation length. The use of modular BKA has acceptable short-term outcomes, but more long-term data are needed before it can be recommended for routine use in the treatment of MPFOA. The selection of modular BKA should be determined on a patient-specific basis. Currently, there is no evidence to suggest the use of monolithic BKA designs because of their high revision and failure rate.

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Section: Introductionsupporting

confidence: 52%

Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis

2017

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“… 33 Indeed, the association between PFA and UKA allows for retaining of the medial pivot, with consequent better knee kinematic. 68 This procedure can be performed in young patients or in elderly patients with severe comorbidities because of the less invasiveness of the surgery compared with TKA. 23 Some authors have described promising results for PFA associated to UKA.…”

Section: Results: Literature Reviewmentioning

confidence: 99%

Patellofemoral Arthroplasty: Current Concepts and Review of the Literature

Pisanu

Rosso

Bertolo

et al. 2017

Joints

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Patellofemoral osteoarthritis (PFOA) can be associated with anterior knee pain, stiffness, and functional impairment. Some authors report that PFOA affects approximately 9% of patients older than 40 years with a greater prevalence in females. Etiology of PFOA is multifactorial and is related to the presence of abnormal stresses at the PF joint due to knee- and patient-related factors. The need for a joint preserving treatment by isolated replacement of the injured compartment of the knee led to the development of PF arthroplasty (PFA). When a correct PF replacement is performed, PFA preserves physiologic tibiofemoral joint, thus allowing patients for a rapid recovery with a high satisfaction. The outcomes for PFA are quite variable with a trend toward good to excellent results, mainly owing to the improvement in surgical techniques, patient selection, and implant design. The development of the second generation of PFA improved the outcomes, which is attributed to the different trochlear designs. Recently, encouraging results have been provided by the association of PFA and unicompartmental knee arthroplasty (UKA). In many studies, the main cause of PFA failure is progression of tibiofemoral OA. The aim of this brief review of literature is to summarize the clinical features, indications and contraindications, surgical techniques, complications, and outcomes of PFA.

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“…Weight acceptance occurs as early as 20% of the gait cycle after initial foot contact and loading (0%-10%) and continues through single leg support up to 50%, or when double stance occurs when the contralateral limb makes contact after swing phase. 27 Both GRF (10%-30% stance) and KA 14,19 (30% stance) differed between knees within groups (TKR) and between groups (TKR and healthy) during weight acceptance in straight gait. Differences in KA for straight gait analysis are well documented in the literature; 14,28 however, an unexpected finding of no differences in KA of the affected knee during straight and turn may be explained by the protocol.…”

Section: Discussionmentioning

confidence: 96%

Analysis of a rotary task following total knee arthroplasty: Stair descent with a cross-over turn

Denney

Ferris

Dai

et al. 2014

Proc Inst Mech Eng H

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Leg loading and knee angle differences have been reported in total knee replacement individuals during straight gait; however, little is known about the impact on the knee during turning. Rotary motions may be difficult following total knee replacement surgery; therefore, some individuals may develop strategies or utilize pre-surgical strategies in order to maintain function. The primary aim of this study was to identify differences in individuals with a total knee replacement as compared to their healthy counterparts during stair descent followed by a cross-over turn. Ground reaction force, knee angle and moments were recorded on 10 total knee replacement and 12 healthy individuals during stair descent followed by a turn and compared to walking straight. Variables were analyzed for the affected, unaffected and healthy knees during the gait cycle. On initial contact, the total knee replacement group had less ground reaction force on the affected leg compared to the unaffected leg (p = 0.021) and had delayed contact (p = 0.044) and a slower loading rate (p = 0.020) compared to healthy group. During mid-stance, the affected leg had less ground reaction force compared to the healthy leg (p = 0.049). The affected stance leg had less knee flexion during mid-stance in both the straight trial (p = 0.002) and turn (p = 0.010). Moment differed between straight and turn trials but not between groups. Stair descent with or without a turn was approached in a precautionary manner by individuals with a total knee replacement. Slow approach, reduced impact and weight-bearing with a more extended knee on the affected leg may suggest a protective strategy to avoid risk of fall.

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Joint kinematics following bi-compartmental knee replacement during daily life motor tasks

Cited by 38 publications

References 30 publications

Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis

Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis

Patellofemoral Arthroplasty: Current Concepts and Review of the Literature

Analysis of a rotary task following total knee arthroplasty: Stair descent with a cross-over turn

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