Prospective sequential comparison of femoral roll-back between cruciate-retaining and posterior-stabilized total knee arthroplasty using an intra-operative sensor |
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| Institution: | 1. Department of Orthopedic Surgery, Moocheok Joeun Hospital, Paju, Republic of Korea;2. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea;1. Institute of Applied Health Sciences, University of Aberdeen, NHS Grampian, AB24 3FX, United Kingdom;2. University of Groningen, University Medical Centre Groningen, Groningen 9713 GZ, the Netherlands;3. Trauma and Orthopaedics, Dr Gray''s Hospital, Elgin, NHS Grampian, IV30 1SN, United Kingdom;1. Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy;2. Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy;3. Engineering, Global Orthopaedics, Sydney, Australia;4. Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;5. Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA;1. Department of Orthopedics and Sports Medicine, The First Affiliated Hospital of Soochow University, Suzhou, PR China;2. Suzhou Medical College of Soochow University, Suzhou, PR China;3. Department of Orthopedics, Wujiang Fourth People’s Hospital, Wujiang, Suzhou, PR China;1. Department of Orthopaedic Surgery, Martini Hospital, Groningen, The Netherlands;2. Department of Radiology, Martini Hospital, Groningen, The Netherlands;1. Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil;2. Hospital Sírio Libanês, São Paulo, Brazil |
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| Abstract: | BackgroundImplant design and surgical techniques affect postoperative knee kinematics in total knee arthroplasty (TKA). This study aimed to compare femoral roll-back between cruciate-retaining (CR) and posterior-stabilized (PS) TKA in the same knee by objectively quantifying the contact point kinematics of the tibiofemoral joint using a sensor.MethodsIn the present prospective study, we used an intraoperative sensor to compare medial and lateral roll-back during 0-120° knee flexion in 33 knees that underwent CR and PS TKA. We also examined the relationship between mediolateral balance and the lateral-to-medial roll-back ratio. We defined the contact percentage position as the vertical length to the contact point divided by the anteroposterior length of the tibial plate.ResultsThe roll-back percentage following PS TKA (19.8 ± 5.1%) was significantly higher than that after CR TKA in both the medial (19.8 ± 5.1% versus 7.1 ± 2.5%, P < 0.001) and lateral (26.8% ± 3.8% versus 18.7 ± 3.8%, P < 0.001) compartments. The medial contact pressure at 90° was significantly correlated with the increased lateral-to-medial roll-back ratio in both CR and PS TKA (both P < 0.001).ConclusionPS TKA resulted in a higher percentage of femoral roll-back in the medial and lateral compartments than CR TKA. CR TKA caused a higher lateral-to-medial roll-back ratio compared to PS TKA. To reproduce medial pivot knee motion similar to that of a normal knee, the medial soft tissue needed to be balanced more tightly than the lateral soft tissue during TKA. These findings provide some clinical evidence of TKA design selection and proper mediolateral balancing for successful TKA. |
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| Keywords: | Total knee arthroplasty Cruciate-retaining Posterior-stabilized Femoral roll-back |
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