In vivo kinematic comparison of bi-cruciate retaining total knee arthroplasty between mechanical alignment and functional alignment methods

Tomofumi Kage , Kenichi Kono , Tetsuya Tomita , Takaharu Yamazaki , Shuji Taketomi , Ryota Yamagami , Kohei Kawaguchi , Ryo Murakami , Takahiro Arakawa , Takashi Kobayashi , Sakae Tanaka , Hiroshi Inui
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引用次数: 0

Abstract

Background/objective

This study aimed to clarify the kinematics of bi-cruciate-retaining (BCR) total knee arthroplasty (TKA) by comparing the mechanical alignment (MA) and functional alignment (FA) methods and to evaluate differences between the two alignment methods.

Methods

The in vivo kinematics of 20 MA TKA and 20 FA TKA knees were investigated under fluoroscopy during squatting using a two-to three-dimensional registration technique. Accordingly, knee flexion angle, axial rotational angle, varus–valgus angle, anteroposterior translation of the medial and lateral low contact points of the femoral component relative to the tibial component and kinematic pathway were evaluated.

Results

No difference in the knee flexion angle was observed between the MA and FA TKA groups. Femoral external rotation was observed in both groups and no significant difference was observed. Significant varus alignment from extension to early flexion range was observed in the FA TKA group. The posterior translation of the medial side was smaller in the FA TKA group than in the MA TKA group. Conversely, no significant difference in the anteroposterior translation of the lateral side was observed. In the kinematic pathway, a medial pivot motion from 0° to 20° of flexion and a lateral pivot motion beyond 20° of flexion were observed in both groups.

Conclusion

During squatting in BCR TKA, the FA TKA group significantly showed varus alignment and smaller posterior translation of the medial side than the MA TKA group from extension to early flexion range.

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双韧带固定全膝关节置换术机械对位法和功能对位法的体内运动学比较
背景/目的:本研究旨在通过比较机械性对位(MA)和功能性对位(FA)方法,阐明双韧带固定(BCR)全膝关节置换术(TKA)的运动学特性,并评估两种对位方法之间的差异。方法:采用二维到三维登记技术,在透视下研究了下蹲时 20 个 MA TKA 和 20 个 FA TKA 膝关节的活体运动学特性。相应地,膝关节屈曲角、轴向旋转角、屈髋角、股骨构件内侧和外侧低接触点相对于胫骨构件的前向平移以及运动路径都得到了评估。两组的股骨外旋均无明显差异。在 FA TKA 组中,从伸展到早期屈曲范围内观察到明显的屈曲对齐。与 MA TKA 组相比,FA TKA 组的内侧后移较小。相反,外侧的前后平移没有明显差异。结论在 BCR TKA 下蹲时,从伸展到早期屈曲范围内,FA TKA 组比 MA TKA 组明显表现出内侧屈曲对齐和较小的内侧后移。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
21
审稿时长
98 days
期刊介绍: The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.
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