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Influence of intra-operative joint gaps on post-operative flexion angle in posterior cruciate-retaining total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to examine the joint component gap and its relationship with post-operative flexion angles in posterior cruciate-retaining (CR) total knee arthroplasty (TKA). In posterior-stabilized (PS) TKA, an inverse correlation between the joint component gap and the post-operative flexion angle was reported. However, the kinematics of the joint component gap has a different pattern in PS and CR TKA. It was hypothesised that CR TKA has a different correlation between the joint component gap and the post-operative flexion angle compared to PS TKA.

Methods

The joint component gap was measured with an offset-type tensor. The joint component gaps were measured at 0°, 10°, 30°, 60°, 90° and 120° knee flexion angle and various values of the change in the joint component gap were calculated; 10°–0°, 30°–0°, 60°–0°, 90°–0° and 120°–0°. Multivariate regression analysis was used to determine the influencing of these parameters to post-operative knee flexion angle.

Results

The post-operative flexion angle was positively correlated with a joint component gap of 90° and 120° and the values of the change in the joint component gap of 90°–0° and 120°–0°. Multivariate regression analysis demonstrated pre-operative knee flexion angle, and the values of the change in the joint component gap of 90°–0° had a significant independent factor of post-operative knee flexion angle.

Conclusions

Post-operative flexion angle is multi-factorial. However, it is important to avoid flexion component gap tightness as well as excessive flexion component gap looseness for acquisition of better flexion angle in CR TKA.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Koji Takayama, Tomoyuki Matsumoto, Seiji Kubo, Takehiko Matsushita, Masahiro Kurosaka & Ryosuke Kuroda

  2. Department of Orthopaedic Surgery, Nippon Steel Hirohata Hospital, Himeji, Japan

    Hirotsugu Muratsu

  3. Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, Japan

    Kazunari Ishida

Authors
  1. Koji Takayama
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  2. Tomoyuki Matsumoto
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  3. Seiji Kubo
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  4. Hirotsugu Muratsu
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  5. Kazunari Ishida
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  6. Takehiko Matsushita
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  7. Masahiro Kurosaka
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  8. Ryosuke Kuroda
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Correspondence to Tomoyuki Matsumoto.

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Takayama, K., Matsumoto, T., Kubo, S. et al. Influence of intra-operative joint gaps on post-operative flexion angle in posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20, 532–537 (2012). https://doi.org/10.1007/s00167-011-1594-x

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