The influence of postoperative knee stability on patient satisfaction in cruciate-retaining total knee arthroplasty

Kamenaga, Tomoyuki; Muratsu, Hirotsugu; Kataoka, Kunio; Yahiro, Shunsuke; Kanda, Yutaro; Oshima, Takashi; Koga, Takaaki; Matsumoto, Tomoyuki; Maruo, Akihiro; Miya, Hidetoshi; Kuroda, Ryosuke

doi:10.1016/j.asmart.2017.05.022

Cited by 7 publications

(11 citation statements)

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“…Posterior-stabilized (PS) TKA with MPGT provides more consistent intraoperative soft tissue balance during knee flexion than MRT. 7 However, postoperative knee stability especially in medial compartment, which was reported as an important factor associated with postoperative ambulation function and patient satisfaction, 8 has not been investigated in the knees after PS-TKA with MPGT.…”

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confidence: 99%

Knee Stability following Posterior-Stabilized Total Knee Arthroplasty: Comparison of Medial Preserving Gap Technique and Measured Resection Technique

Tsubosaka

Muratsu²,

Nakano

et al. 2021

J Knee Surg

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Novel medial preserving gap technique (MPGT) focuses on medial compartment stability and allows lateral physiological laxity. This study aimed to compare the MPGT with the measured resection technique (MRT) to determine which provides better postoperative knee stability after posterior-stabilized total knee arthroplasty (PS-TKA). Primary PS-TKA, using either MPGT (n = 65) or MRT (n = 65), was performed in 130 patients with varus knee osteoarthritis. Postoperative knee stabilities at extension and flexion were assessed using varus–valgus stress radiographs and stress epicondylar view, respectively (at 1 month, 6 months, 1 year, and 3 years postoperatively). The distance between the femoral prosthesis and polyethylene insert was measured on each medial and lateral side, defined as the medial joint opening (MJO) and lateral joint opening (LJO), respectively. Decreasing MJO or LJO translated to increasing postoperative stability. The femoral external rotation angle was compared between the two surgical techniques; postoperative knee stability was also compared between the medial and lateral compartments, as well as the surgical techniques. A significant difference was found in the femoral external rotation angle between MPGT (4.2 ± 0.2 degrees) and MRT (3.6 ± 0.1 degrees, p < 0.01). Postoperative MJOs both at extension and flexion were significantly smaller than LJOs using MPGT and MRT at all time points (p < 0.05). MJOs and LJOs at extension using MPGT were significantly smaller than those when using MRT, at 1 and 3 years postoperatively (p < 0.05). Furthermore, MJOs at flexion using MPGT were significantly smaller than those when using MRT at 6 months, 1 year, and 3 years postoperatively (p < 0.05). MPGT provided higher postoperative medial knee stability than MRT both at extension and flexion, even at 3 years after PS-TKA. This suggests that this newly developed surgical technique is a more feasible option than MRT for the preservation of postoperative medial knee stability.

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confidence: 99%

Knee Stability following Posterior-Stabilized Total Knee Arthroplasty: Comparison of Medial Preserving Gap Technique and Measured Resection Technique

Tsubosaka

Muratsu²,

Nakano

et al. 2021

J Knee Surg

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“…The reported satisfaction scores of other TKA designs (posterior stabilized, cruciate retaining, cruciate sacrificing) ranged from 21 to 26. 25,26,[37][38][39][40][41][42] BCS TKA might be recommended for surgeons because just maintaining medial stability in flexion proved to be enough to achieve excellent patient satisfaction. However, to know whether BCS TKA is truly superior to other TKA designs, we must compare the satisfaction scores between BCS and other designs of TKAs in patients with similar demographics.…”

Section: Discussionmentioning

confidence: 99%

Preoperative and intraoperative factors contributing to patient satisfaction after bi-cruciate stabilized total knee arthroplasty

Inui

Taketomi

Yamagami

et al. 2021

J Orthop Surg (Hong Kong)

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Background: One of the causes of dissatisfaction following total knee arthroplasty (TKA) is abnormal knee kinematics. A newly designed bi-cruciate stabilized (BCS) TKA system has been developed to produce close-to-normal kinematics because of its anatomic tibiofemoral articular geometry and cam-post mechanism. Although BCS TKA is expected to improve patient satisfaction, no reports have described the appropriate technique or soft tissue handling required to achieve excellent satisfaction with BCS TKA. This study is to identify preoperative and intraoperative predictors of patient satisfaction after BCS TKA. Methods: Altogether, we studied 113 knees with primary varus knee osteoarthritis that underwent BCS TKA with a navigation system. Preoperative parameters including Knee Society Score and patient-reported scores [the Knee injury and Osteoarthritis Outcome Score (KOOS)] and intraoperative parameters including coronal, sagittal and axial alignment and joint laxity in each compartment that affected patient satisfaction was evaluated. Satisfaction score was evaluated with use of the 2011 Knee Society Scoring system. The multivariate regression analysis included age and preoperative and intraoperative parameters that correlated with satisfaction scores in the univariate analysis ( P < 0.05). Results: The mean satisfaction score was 28.2 ± 6.1. Multivariate regression analysis showed that the predictors of patient satisfaction were a preoperative high KOOS score for activities of daily living ( P < 0.001), male sex ( P = 0.005), older age ( P = 0.027), and minimal medial joint laxity during flexion ( P = 0.031). Conclusion: When performing BCS TKA, surgeons should pay attention to maintaining proper stability of the medial compartment, especially during flexion.

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“…The 2011 KSS was reported to be a reliable, internally consistent, and responsive questionnaire with construct validity when used to assess the outcomes of TKA patients [19]. Recently, Kamenaga et al [20] showed that lateral laxity at extension after CR TKA was significantly correlated with the better patient satisfaction in the 2011 KSS [20].…”

Section: Discussionmentioning

confidence: 99%

Influence of limb alignment and prosthetic orientation on patient-reported clinical outcomes in total knee arthroplasty

Kuroda

Takayama

Ishida

et al. 2019

Journal of Orthopaedic Science

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The influence of postoperative knee stability on patient satisfaction in cruciate-retaining total knee arthroplasty

Cited by 7 publications

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Knee Stability following Posterior-Stabilized Total Knee Arthroplasty: Comparison of Medial Preserving Gap Technique and Measured Resection Technique

Knee Stability following Posterior-Stabilized Total Knee Arthroplasty: Comparison of Medial Preserving Gap Technique and Measured Resection Technique

Preoperative and intraoperative factors contributing to patient satisfaction after bi-cruciate stabilized total knee arthroplasty

Influence of limb alignment and prosthetic orientation on patient-reported clinical outcomes in total knee arthroplasty

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