Skip to main content
SpringerLink
Log in

Changes in anteroposterior stability and proprioception after different types of knee arthroplasty

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

Abstract

Purpose

To compare different types of knee arthroplasty, in selected patients with a knee score above 80 points, for their post-operative changes in anteroposterior (AP) laxity and proprioception.

Methods

Four groups of each ten patients were tested for AP translation after different types of arthroplasty with a KT-1000 device at 30°, 60° and 90° of flexion. Proprioception of the joint was evaluated by joint position sense with three different tests. Clinical outcome of stability and proprioceptive testing was analysed by comparing the results of three (KSS, KOOS and FJS-12) patient-reported outcome measurement scores (PROMS) for each of the different implant types.

Results

Anteroposterior laxity was observed at 30° and 90° of flexion for the two PS TKA designs included in this study, but not for the UKA or the medial pivot design. All knee designs, except UKA, had an increased laxity at 60° of flexion. Proprioceptive testing was inconclusive. PROMS were not able to identify differences in clinical outcome among different knee designs in these selected patients, despite observed differences in AP laxity.

Conclusion

Increased AP laxity is a result of the surgical procedure in knee arthroplasty. UKA is the only design mimicking native laxity of the knee. A medial pivot design can obtain the same result as UKA at 30° and 90° of flexion, but not at the importantly cited 60° of flexion as tested under non-load-bearing conditions. The clinical relevance of this study is that despite of an important range of AP translations among the different knee designs, good-to-excellent patient-reported outcome was observed within the findings of this study.

Level of evidence

II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abdel MP, Pulido L, Severson EP, Hanssen AD (2014) Stepwise surgical correction of instability in flexion after total knee replacement. Bone Joint J 96-B(12):1644–1648

    Article  CAS  PubMed  Google Scholar 

  2. Arellano CJ, Layne CS, O’Connor DP, Scott-Pandorf M, Kurz MJ (2009) Does load carrying influence sagittal plane locomotive stability? Med Sci Sports Exerc 41(3):620–627

    Article  PubMed  Google Scholar 

  3. Bai B, Baez J, Testa N, Kummer FJ (2000) Effect of posterior cut angle on tibial component loading. J Arthroplasty 15(7):916–920

    Article  CAS  PubMed  Google Scholar 

  4. Becker R, Mauer C, Starke C, Brosz M, Zantop T, Lohmann CH, Schulze M (2013) Anteroposterior and rotational stability in fixed and mobile bearing unicondylar knee arthroplasty: a cadaveric study using the robotic force sensor system. Knee Surg Sports Traumatol Arthrosc 21(11):2427–2432

    Article  PubMed  Google Scholar 

  5. Behrend H, Giesinger K, Giesinger JM, Kuster MS (2012) The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 27(3):430–436

    Article  PubMed  Google Scholar 

  6. Bellemans J, Banks S, Victor J, Vandenneucker H, Moemans A (2002) Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty. Influence of posterior condylar offset. J Bone Joint Surg Br 84(1):50–53

    Article  CAS  PubMed  Google Scholar 

  7. Brage ME, Draganich LF, Pottenger LA, Curran JJ (1994) Knee laxity in symptomatic osteoarthritis. Clin Orthop Relat Res 304:184–189

    Google Scholar 

  8. Daniel DM, Stone ML, Sachs R, Malcom L (1985) Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med 13(6):401–407

    Article  CAS  PubMed  Google Scholar 

  9. Dargel J, Feiser J, Gotter M, Pennig D, Koebke J (2009) Side differences in the anatomy of human knee joints. Knee Surg Sports Traumatol Arthrosc 17(11):1368–1376

    Article  PubMed  Google Scholar 

  10. Dayal N, Chang A, Dunlop D, Hayes K, Chang R, Cahue S, Song J, Torres L, Sharma L (2005) The natural history of anteroposterior laxity and its role in knee osteoarthritis progression. Arthritis Rheum 52(8):2343–2349

    Article  PubMed  Google Scholar 

  11. Dunbar MJ, Richardson G, Robertsson O (2013) I can’t get no satisfaction after my total knee replacement: rhymes and reasons. Bone Joint J 95-B(11 Suppl A):148–152

    Article  CAS  PubMed  Google Scholar 

  12. Hart HF, Culvenor AG, Collins NJ, Ackland DC, Cowan SM, Machotka Z, Crossley KM (2015) Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Br J Sports Med. doi:10.1136/bjsports-2015-094797

    Google Scholar 

  13. Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86-A(3):506–511

    Article  PubMed  Google Scholar 

  14. Heyse TJ, Becher C, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO (2010) Quadriceps force in relation of intrinsic anteroposterior stability of TKA design. Arch Orthop Trauma Surg 130(1):1–9

    Article  PubMed  Google Scholar 

  15. Hino K, Ishimaru M, Iseki Y, Watanabe S, Onishi Y, Miura H (2013) Mid-flexion laxity is greater after posterior-stabilised total knee replacement than with cruciate-retaining procedures: A computer navigation study. Bone Joint J 95-B(4):493–497

    Article  CAS  PubMed  Google Scholar 

  16. Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2005) Sagittal laxity in vivo after total knee arthroplasty. Arch Orthop Trauma Surg 125(4):249–253

    Article  PubMed  Google Scholar 

  17. Ishii Y, Noguchi H, Takeda M, Sato J, Toyabe S (2014) Anteroposterior translation does not correlate with knee flexion after total knee arthroplasty. Clin Orthop Relat Res 472(2):704–709

    Article  PubMed  Google Scholar 

  18. Johal P, Hassaballa MA, Eldridge JD, Porteous AJ (2012) The posterior condylar offset ratio. Knee 19(6):843–845

    Article  PubMed  Google Scholar 

  19. Jones DP, Locke C, Pennington J, Theis JC (2006) The effect of sagittal laxity on function after posterior cruciate-retaining total knee replacement. J Arthroplasty 21(5):719–723

    Article  PubMed  Google Scholar 

  20. Knoop J, Steultjens MP, van der Leeden M, van der Esch M, Thorstensson CA, Roorda LD, Lems WF, Dekker J (2011) Proprioception in knee osteoarthritis: a narrative review. Osteoarthr Cartil 19(4):381–388

    Article  CAS  PubMed  Google Scholar 

  21. Koninckx A, Schwab PE, Deltour A, Thienpont E (2014) The minimally invasive far medial subvastus approach for total knee arthroplasty in valgus knees. Knee Surg Sports Traumatol Arthrosc 22(8):1765–1770

    Article  PubMed  Google Scholar 

  22. Koralewicz LM, Engh GA (2000) Comparison of proprioception in arthritic and age-matched normal knees. J Bone Joint Surg Am 82-A(11):1582–1588

    Article  CAS  PubMed  Google Scholar 

  23. Krackow KA, Mihalko WM (1999) Flexion-extension joint gap changes after lateral structure release for valgus deformity correction in total knee arthroplasty: a cadaveric study. J Arthroplasty 14(8):994–1004

    Article  CAS  PubMed  Google Scholar 

  24. Meric G, Gracitelli GC, Aram LJ, Swank ML, Bugbee WD (2015) Variability in distal femoral anatomy in patients undergoing total knee arthroplasty: measurements on 13,546 computed tomography scans. J Arthroplasty. doi:10.1016/j.arth.2015.04.024

    Google Scholar 

  25. Nguyen LC, Lehil MS, Bozic KJ (2015) Trends in total knee arthroplasty implant utilization. J Arthroplasty 30(5):739–742

    Article  PubMed  Google Scholar 

  26. Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43

    Article  PubMed  Google Scholar 

  27. Oka S, Matsumoto T, Muratsu H, Kubo S, Matsushita T, Ishida K, Kuroda R, Kurosaka M (2014) The influence of the tibial slope on intra-operative soft tissue balance in cruciate-retaining and posterior-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(8):1812–1818

    Article  PubMed  Google Scholar 

  28. Okamoto S, Mizu-Uchi H, Okazaki K, Hamai S, Nakahara H, Iwamoto Y (2015) Effect of tibial posterior slope on knee kinematics, quadriceps force, and patellofemoral contact force after posterior-stabilized total knee arthroplasty. J Arthroplasty 30(8):1439–1443

    Article  PubMed  Google Scholar 

  29. Pai YC, Rymer WZ, Chang RW, Sharma L (1997) Effect of age and osteoarthritis on knee proprioception. Arthritis Rheum 40(12):2260–2265

    Article  CAS  PubMed  Google Scholar 

  30. Paternostre F, Schwab PE, Thienpont E (2014) The combined Whiteside’s and posterior condylar line as a reliable reference to describe axial distal femoral anatomy in patient-specific instrument planning. Knee Surg Sports Traumatol Arthrosc 22(12):3054–3059

    Article  PubMed  Google Scholar 

  31. Scott CE, Howie CR, MacDonald D, Biant LC (2010) Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br 92(9):1253–1258

    Article  CAS  PubMed  Google Scholar 

  32. Seon JK, Park SJ, Yoon TR, Lee KB, Moon ES, Song EK (2010) The effect of anteroposterior laxity on the range of movement and knee function following a cruciate-retaining total knee replacement. J Bone Joint Surg Br 92(8):1090–1095

    Article  CAS  PubMed  Google Scholar 

  33. Sernert N, Helmers J, Kartus C, Ejerhed L, Kartus J (2007) Knee-laxity measurements examined by a left-hand- and a right-hand-dominant physiotherapist, in patients with anterior cruciate ligament injuries and healthy controls. Knee Surg Sports Traumatol Arthrosc 15(10):1181–1186

    Article  PubMed  Google Scholar 

  34. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428

    Article  CAS  PubMed  Google Scholar 

  35. Stan G, Orban H, Orban C, Petcu D, Gheorghe P (2013) The influence of total knee arthroplasty on postural control. Chirurgia (Bucur) 108(6):874–878

    CAS  Google Scholar 

  36. Suero EM, Citak M, Cross MB, Bosscher MR, Ranawat AS, Pearle AD (2012) Effects of tibial slope changes in the stability of fixed bearing medial unicompartmental arthroplasty in anterior cruciate ligament deficient knees. Knee 19(4):365–369

    Article  PubMed  Google Scholar 

  37. Suggs JF, Li G, Park SE, Steffensmeier S, Rubash HE, Freiberg AA (2004) Function of the anterior cruciate ligament after unicompartmental knee arthroplasty: an in vitro robotic study. J Arthroplasty 19(2):224–229

    Article  PubMed  Google Scholar 

  38. Swanik CB, Lephart SM, Rubash HE (2004) Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am 86-A(2):328–334

    Article  PubMed  Google Scholar 

  39. Thiele K, Perka C, Matziolis G, Mayr HO, Sostheim M, Hube R (2015) Current failure mechanisms after knee arthroplasty have changed: polyethylene wear is less common in revision surgery. J Bone Joint Surg Am 97(9):715–720

    Article  PubMed  Google Scholar 

  40. Thienpont E, Opsomer G, Koninckx A, Houssiau F (2014) Joint awareness in different types of knee arthroplasty evaluated with the forgotten joint score. J Arthroplasty 29(1):48–51

    Article  PubMed  Google Scholar 

  41. Thienpont E, Schwab PE, Omoumi P (2014) Wear patterns in anteromedial osteoarthritis of the knee evaluated with CT-arthrography. Knee 21(Suppl 1):S15–S19

    Article  PubMed  Google Scholar 

  42. Valkering KP, Breugem SJ, van den Bekerom MP, Tuinebreijer WE, van Geenen RC (2015) Effect of rotational alignment on outcome of total knee arthroplasty. Acta Orthop 86(4):432–439

    Article  PubMed  PubMed Central  Google Scholar 

  43. van Hal CT, van Hellemondt GG, Wymenga AB, Jacobs WC (2007) The anterior-posterior laxity after total knee arthroplasty inserted with a ligament tensor. Knee Surg Sports Traumatol Arthrosc 15(8):1019–1022

    Article  PubMed  Google Scholar 

  44. Voos JE, Suero EM, Citak M, Petrigliano FP, Bosscher MR, Citak M, Wickiewicz TL, Pearle AD (2012) Effect of tibial slope on the stability of the anterior cruciate ligament-deficient knee. Knee Surg Sports Traumatol Arthrosc 20(8):1626–1631

    Article  PubMed  Google Scholar 

  45. Wada M, Kawahara H, Shimada S, Miyazaki T, Baba H (2002) Joint proprioception before and after total knee arthroplasty. Clin Orthop Relat Res 403:161–167

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University Hospital Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Delphine Wautier & Emmanuel Thienpont

Authors
  1. Delphine Wautier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emmanuel Thienpont
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emmanuel Thienpont.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wautier, D., Thienpont, E. Changes in anteroposterior stability and proprioception after different types of knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25, 1792–1800 (2017). https://doi.org/10.1007/s00167-016-4038-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-016-4038-9

Keywords

Search

Navigation