Skip to main content

Kinematics of the knee after unicompartmental arthroplasty is not the same as normal and is similar to the kinematics of the knee with osteoarthritis

Knee Surgery, Sports Traumatology, Arthroscopy volume 22, pages 1911–1917 (2014)Cite this article

Abstract

Purpose

It is common to assert that restoration of normal knee kinematics is essential for the best functional result after knee arthroplasty. Previous studies using the progression of the geometric centre axis have suggested that kinematics after unicompartmental arthroplasty is markedly different from the normal. For this study, the transepicondylar axis was used because this axis is closer to the flexion axis and should be a better reference for motion. The following hypothesis was tested: the transepicondylar axis would again show that the postoperative kinematics does not restore normal motion and is closer to that before replacement.

Methods

Seventeen osteoarthritic knees were tested before and after unicompartmental arthroplasty using a three-dimensional to two-dimensional registration technique tracking the transepicondylar axis to calculate translation and rotation of this axis. Results were compared for the seventeen knees before and after arthroplasty and were compared to the normal knee as measured in our previous study.

Results

Similar motion patterns in the pre- and postoperative knees were shown but both the pre- and postoperative motion were markedly different from the normal knee.

Conclusions

This result supported our hypothesis. The clinical relevance is that medial unicompartmental arthroplasty cannot restore the motion of the knee to normal in the living knee. Therefore, it would be expected that the patient for unicompartmental knee might not feel normal. It may not be possible depending on ligaments alone to restore the knee to normal, and the changes in the articular shapes and the surgical procedure may also be necessary.

Level of evidence

IV.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Asano T, Akagi M, Nakamura T (2005) The functional flexion-extension axis of the knee corresponds to the surgical epicondylar axis: in vivo analysis using a biplanar image matching technique. J Arthroplasty 20:1060–1067

    PubMed  Article  Google Scholar 

  2. Bae DK, Song SJ, Cho SD (2011) Clinical outcome of total knee arthroplasty with medial pivot prosthesis a comparative study between the cruciate retaining and sacrificing. J Arthroplasty 26:693–698

    PubMed  Article  Google Scholar 

  3. Blaha JD (2002) A medial pivot geometry. Orthopedics 25:963–964

    PubMed  Google Scholar 

  4. Blaha JD (2004) The rationale for a total knee implant that confers anteroposterior stability throughout range of motion. J Arthroplasty 19:22–26

    PubMed  Article  Google Scholar 

  5. Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118

    PubMed  Article  Google Scholar 

  6. Deschamps G, Chol C (2011) Fixed-bearing unicompartmental knee arthroplasty. Patients’ selection and operative technique. Orthop Traumatol Surg Res 97:648–661

    CAS  PubMed  Article  Google Scholar 

  7. Fan CY, Hsieh JT, Hsieh MS, Shih YC, Lee CH (2010) Primitive results after medial-pivot knee arthroplasties: a minimum 5-year follow-up study. J Arthroplasty 25:492–496

    PubMed  Article  Google Scholar 

  8. Haaker P, Klotz E, Koppe R, Linde R (1990/1991) Real-time distortion correction of digital X-ray 2/TV-systems an application example for digital flashing tomosynthesis (DFTS). Int J Cardiac Imaging 6:36–45

    Google Scholar 

  9. Hollister AM, Jatana A, Singh AK, Sullivan WW, Lupichuk AG (1993) The axes of rotation of the knee. Clin Orthop Relat Res 290:259–268

    PubMed  Google Scholar 

  10. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–502

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  11. Kobayashi K, Tanaka N, Odagawa K, Sakamoto M, Tanabe Y (2009) Image-based matching for natural knee kinematics measurement using single-plane fluoroscopy. J Jpn Soc Exp Mech 9:162–166

    Google Scholar 

  12. Kobayashi K, Sakamoto K, Tanabe Y, Ariumi A, Sato T, Omori G, Koga Y (2009) Automated image registration for three-dimensional alignment of entire lower extremity and implant position using bi-plane radiography. J Biomech 42:2818–2822

    PubMed  Article  Google Scholar 

  13. Kurosawa H, Walker PS, Abe S, Garg A, Hunter T (1985) Geometry and motion of the knee for implant and orthotic design. J Biomech 18:487–499

    CAS  PubMed  Article  Google Scholar 

  14. Mochizuki T, Sato T, Tanifuji O, Kobayashi K, Koga Y, Yamagiwa H, Omori G, Endo N (2012) In vivo pre- and postoperative three-dimensional knee kinematics in unicompartmental knee arthroplasty. J Orthop Sci. doi:10.1007/s0077601203229

    PubMed Central  Google Scholar 

  15. Most E, Axe J, Rubash H, Li G (2004) Sensitivity of the knee joint kinematics calculation to selection of flexion axes. J Biomech 37:1743–1748

    CAS  PubMed  Article  Google Scholar 

  16. Patil S, Colwell CW Jr, Ezzet KA, D’Lima DD (2005) Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am 87:332–338

    PubMed  Article  Google Scholar 

  17. Pritchett JW (2011) Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty 26:224–228

    PubMed  Article  Google Scholar 

  18. Sato T, Koga Y, Omori G (2004) Three-dimensional lower extremity alignment assessment system. J Arthroplasty 19:620–628

    PubMed  Article  Google Scholar 

  19. Tanifuji O, Sato T, Kobayashi K, Mochizuki T, Koga Y, Yamagiwa H, Omori G, Endo N (2011) Three-dimensional in vivo motion analysis of normal knees using single-plane fluoroscopy. J Orthop Sci 16:710–718

    PubMed  Article  Google Scholar 

  20. Tanifuji O, Sato T, Kobayashi K, Mochizuki T, Koga Y, Yamagiwa H, Omori G, Endo N (2012) Three-dimensional in vivo motion analysis of normal knees employing transepicondylar axis as an evaluation parameter. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s001670122010x

    PubMed  Google Scholar 

Download references

Acknowledgments

This study would have been impossible without the cooperation of the Department of Radiology, Niigata Medical Center and Niigata University Hospital. The authors would like to thank all staff members of the department. The authors would also like to thank all staff members of LEXI Corporation, Tokyo, Japan, for their technical support.

Conflict of interest

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

Author information

Affiliations

  1. Department of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Tomoharu Mochizuki, Osamu Tanifuji, Hiroshi Yamagiwa & Naoto Endo

  2. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Tomoharu Mochizuki & John David Blaha

  3. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Tomoharu Mochizuki, Takashi Sato, Satoshi Watanabe & Yoshio Koga

  4. Department of Health Sciences, Niigata University School of Medicine, Niigata, Japan

    Koichi Kobayashi

  5. Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata, Japan

    Munenori Matsueda

  6. Center for Transdisciplinary Research, Institute for Research Promotion, Niigata University, Niigata, Japan

    Go Omori

Authors
  1. Tomoharu Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takashi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John David Blaha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Osamu Tanifuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koichi Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroshi Yamagiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Satoshi Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Munenori Matsueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshio Koga
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Go Omori
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Naoto Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoharu Mochizuki.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mochizuki, T., Sato, T., Blaha, J.D. et al. Kinematics of the knee after unicompartmental arthroplasty is not the same as normal and is similar to the kinematics of the knee with osteoarthritis. Knee Surg Sports Traumatol Arthrosc 22, 1911–1917 (2014). https://doi.org/10.1007/s00167-013-2767-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-013-2767-6

Keywords

  • Knee kinematics
  • Transepicondylar axis
  • 3D to 2D registration
  • Squatting
  • Unicompartmental knee arthroplasty