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Similar kinematic patterns between revision total stabilized (TS) and primary posterior stabilized (PS) knee prostheses: a prospective case–controlled study with gait assessment

Abstract

Purpose

There are increased surgical considerations when revising total knee arthroplasty (TKA) in active patients. Few studies have assessed if a semi-constrained [Total Stabilized (TS)] prostheses has similar knee biomechanics to a primary posterior stabilized (PS) prosthesis. The aim was to compare the gait parameters in patients with PS or TS TKA and normal controls.

Methods

32 patients with TKA were prospectively included with either a primary PS (n = 15) or a revision TS (n = 17) prosthesis. Gait analysis was performed at 6 months postoperatively for each patient, with an optoelectronic knee assessment device (KneeKG®) assessing the displacement of the tibia relative to the femur during the different gait phases (flexion/extension, anterior/posterior translation, adduction/abduction, internal/external rotation). A control group (n = 12) of healthy knees was compared with the TKA groups.

Results

There were no significant kinematic differences between PS and TS groups. The maximum knee flexion during gait was 53° ± 8.1° in the PS group vs 52° ± 8.7° in the TS group. The antero-posterior translation was similar in both group (2.3 ± 0.5 mm vs 2.6 ± 0.9 mm, respectively). Peak varus angle during loading and swing phase was slightly higher in the TS group (2.7° ± 0.7° and 5.2° ± 0.9°) than in the PS group (2.9° ± 0.6° and 5.6° ± 1.2°), without significant difference. The ranges in internal/external rotation were similar between PS and TS TKA (3.7° ± 0.5° vs 3.3° ± 0.6°, respectively). Both designs approached closely the normal gait patterns of the control group except in the frontal plane.

Conclusion

Single radius TS TKA has gait parameters similar to single radius PS TKA. Use of a single radius TS TKA in revision TKA is not detrimental to a patient’s gait pattern. Both designs approached closely the normal gait patterns of the control group.

Level of evidence

Prospective, case–control study; Level III.

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Abbreviations

BMI:

Body mass index

FJS:

Forgotten joint score

FMA:

Femoral mechanical angle

HKA:

Hip knee ankle

IKS:

International knee score

OA:

Osteoarthritis

PS:

Postero-stabilized

ROM:

Range of motion

TKA:

Total knee arthroplasty

TMA:

Tibial mechanical angle

TS:

Total-stabilized

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Funding

Prospective controlled study funded by Stryker®.

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Authors and Affiliations

Authors

Contributions

CB: study design, data collection, literature review and manuscript writing. CoFO: data collection, statistical analysis, literature review and manuscript writing. CaFA: study design, literature review and manuscript editing. AN: statistical analysis and manuscript editing. ES: study design, literature review and manuscript editing. SL: study design, supervision, literature review and manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cécile Batailler.

Ethics declarations

Conflict of interest

CB, CoFo, and AN declare that they have no conflict of interest. CaFa: consultant for Zimmer/Biomet. ES: consultant for Corin. SL: consultant for Stryker, Smith Nephew, Heraeus, Depuy Synthes; institutional research support from Groupe Lepine, Amplitude; Editorial Board for Journal of Bone and Joint Surgery (Am).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was registered at ClinicalTrials.gov (Identifier: NCT03898544) and was approved by our hospital’s Institutional Review Board as a Prospective Case Control study (study ID Number: 69HCL19_0089).

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Cite this article

Batailler, C., Foissey, C., Fary, C. et al. Similar kinematic patterns between revision total stabilized (TS) and primary posterior stabilized (PS) knee prostheses: a prospective case–controlled study with gait assessment. Knee Surg Sports Traumatol Arthrosc 30, 2714–2722 (2022). https://doi.org/10.1007/s00167-021-06591-y

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  • DOI: https://doi.org/10.1007/s00167-021-06591-y

Keywords

  • Total knee arthroplasty
  • Revision surgery
  • Posterior stabilized knee prothesis
  • Total stabilized knee prothesis
  • Semi-constrained prostheses
  • Gait analysis