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Functional versus patient-reported outcome of the bicruciate and the standard condylar-stabilizing total knee arthroplasty

  • Alberto VascellariEmail author
  • Stefano Schiavetti
  • Enrico Rebuzzi
  • Nicolò Coletti
Original Article • KNEE - ARTHROPLASTY

Abstract

Introduction

The purpose of this retrospective comparative analysis in patients undergoing primary total knee arthroplasty (TKA) was to evaluate whether different TKA implant design would influence patient-rated outcomes, functioning, and range of motion (ROM). A secondary purpose of this study was to test for relationships between the patient-rated outcomes and the passive ROM.

Materials and methods

Thirty-one patients who had a primary bicruciate stabilized TKA performed between May 2010 and November 2012 were retrospectively reviewed and compared with a cohort of 30 patients who had condylar-stabilizing TKA during the same period.

Results

No significant differences were observed between the two groups with respect to preoperative demographic characteristics, ROM and radiographic knee alignment. At a mean follow-up of 37 months (SD 7), the Triathlon group had higher mean Knee Injury and Osteoarthritis Outcome Score (KOOS) score in all subscales and a higher Knee Society Score (KSS) score than the Journey group. This difference was statistically significant for the KOOS subscales of pain (p = 0.0099) and activities of daily living (ADL) (p = 0.0003), as well as the KSS score (p = 0.03846). The ROM was significantly higher in the Journey group when compared to the Triathlon group (p = 0.0013). No significant correlation was observed between the ROM and KOOS pain, QOL and ADL subscores and KSS score.

Conclusions

Postoperative knee ROM and patient perception of knee function after primary TKA can be affected by the different prosthetic designs. However, functionality afforded by the bicruciate TKA is not equivalent to patient satisfaction.

Level of evidence

III.

Keywords

Total knee arthroplasty Prosthetic design KOOS Score KSS score Clinical outcome Range of movement 

Notes

Acknowledgments

The authors are grateful to Mara Buoro, Lina Fiorin, and Valeria Martin of the Oderzo Hospital Orthopaedic and Traumatology Department for their valuable assistance during follow-up and data management.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical standards

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.

References

  1. 1.
    Argenson JN, Parratte S, Ashour A, Komistek RD, Scuderi GR (2008) Patient-reported outcome correlates with knee function after a single-design mobile-bearing TKA. Clin Orthop Relat Res 466:2669–2676CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Devers BN, Conditt MA, Jamieson ML, Driscoll MD, Noble PC, Parsley BS (2011) Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? J Arthroplasty 26:178–186CrossRefPubMedGoogle Scholar
  3. 3.
    Padua R, Ceccarelli E, Bondi R, Campi A, Padua L (2007) Range of motion correlates with patient perception of TKA outcome. Clin Orthop Relat Res 460:174–177PubMedGoogle Scholar
  4. 4.
    Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188CrossRefPubMedGoogle Scholar
  5. 5.
    Lee BS, Kim JM, Lee SJ, Jung KH, Lee DH, Cha EJ, Bin SI (2011) High-flexion total knee arthroplasty improves flexion of stiff knees. Knee Surg Sports Traumatol Arthrosc 19(6):936–942CrossRefPubMedGoogle Scholar
  6. 6.
    Ward TR, Burns AW, Gillespie MJ, Scarvell JM, Smith PN (2011) Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs. J Bone Joint Surg Br 93:907–913CrossRefPubMedGoogle Scholar
  7. 7.
    Catani F, Innocenti B, Belvedere C, Labey L, Ensini A, Leardini A (2010) The mark coventry award: articular contact estimation in TKA using in vivo kinematics and finite element analysis. Clin Orthop Relat Res 468:19–28CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    van Duren BH, Pandit H, Price M, Tilley S, Gill HS, Murray DW, Thomas NP (2012) Bicruciate substituting total knee replacement: how effective are the added kinematic constraints in vivo? Knee Surg Sports Traumatol Arthrosc 20(10):2002–2010CrossRefPubMedGoogle Scholar
  9. 9.
    Victor J, Mueller JK, Komistek RD, Sharma A, Nadaud MC, Bellemans J (2010) In vivo kinematics after a cruciate-substituting TKA. Clin Orthop Relat Res 468:807–814CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Brilhault J, Ries MD (2010) Measuring patellar height using the lateral active flexion radiograph: effect of total knee implant design. Knee 17:148–151CrossRefPubMedGoogle Scholar
  11. 11.
    Catani F, Ensini A, Belvedere C, Feliciangeli A, Benedetti MG, Leardini A, Giannini S (2009) In vivo kinematics and kinetics of a bi-cruciate substituting total knee arthroplasty: a combined fluoroscopic and gait analysis study. J Orthop Res 27:1569–1575CrossRefPubMedGoogle Scholar
  12. 12.
    Conteduca F, Iorio R, Mazza D, Caperna L, Bolle G, Argento G, Ferretti A (2012) Are MRI-based, patient matched cutting jigs as accurate as the tibial guides? Int Orthop 36:1589–1593CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Noble JW Jr, Moore CA, Liu N (2012) The value of patient matched instrumentation in total knee arthroplasty. J Arthroplasty 27:153–155CrossRefPubMedGoogle Scholar
  14. 14.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  15. 15.
    Monticone M, Ferrante S, Salvaderi S, Rocca B, Totti V, Foti C, Roi GS (2012) Development of the Italian version of the knee injury and osteoarthritis outcome score for patients with knee injuries: cross-cultural adaptation, dimensionality, reliability, and validity. Osteoarthr Cartilage 20:330–335CrossRefGoogle Scholar
  16. 16.
    Brosseau L, Tousignant M, Budd J, Chartier N, Duciaume L, Plamondon S, O’Sullivan JP, O’Donoghue S, Balmer S (1997) Intratester and intertester reliability and criterion validity of the parallelogram and universal goniometers for active knee flexion in healthy subjects. Physiother Res Int 2:150–166CrossRefPubMedGoogle Scholar
  17. 17.
    Edwards JZ, Greene KA, Davis RS, Kovacik MW, Noe DA, Askew MJ (2004) Measuring flexion in knee arthroplasty patients. J Arthroplasty 19:369–372CrossRefPubMedGoogle Scholar
  18. 18.
    Marx RG, Grimm P, Lillemoe KA, Robertson CM, Ayeni OR, Lyman S, Bogner EA, Pavlov H (2011) Reliability of lower extremity alignment measurement using radiographs and PACS. Knee Surg Sports Traumatol Arthrosc 19:1693–1698CrossRefPubMedGoogle Scholar
  19. 19.
    Evans JD (1996) Straightforward statistics for the behavioral sciences. Brooks/Cole Publishing, Pacific GroveGoogle Scholar
  20. 20.
    Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2014) Can TKA design affect the clinical outcome? Comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc 22:581–589CrossRefPubMedGoogle Scholar
  21. 21.
    Cook LE, Klika AK, Szubski CR, Rosneck J, Molloy R, Barsoum WK (2012) Functional outcomes used to compare single radius and multiradius of curvature designs in total knee arthroplasty. J Knee Surg 25:249–253CrossRefPubMedGoogle Scholar
  22. 22.
    Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G (2010) Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res 468:1214–1220CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Nutton RW, Wade FA, Coutts FJ, van der Linden ML (2012) Does a mobile-bearing, high-flexion design increase knee flexion after total knee replacement? J Bone Joint Surg Br 94:1051–1057CrossRefPubMedGoogle Scholar
  24. 24.
    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 84:50–53CrossRefPubMedGoogle Scholar
  25. 25.
    Malviya A, Lingard EA, Weir DJ, Deehan DJ (2009) Predicting range of movement after knee replacement: the importance of posterior condylar offset and tibial slope. Knee Surg Sports Traumatol Arthrosc 17:491–498CrossRefPubMedGoogle Scholar
  26. 26.
    Rowe PJ, Myles CM, Walker C, Nutton R (2000) Knee joint kinematics in gait and other functional activities measured using flexible electrogoniometry: how much knee motion is sufficient for normal daily life? Gait Posture 12:143–155CrossRefPubMedGoogle Scholar
  27. 27.
    Tew M, Forster IW, Wallace WA (1989) Effect of total knee arthroplasty on maximal flexion. Clin Orthop Relat Res 247:168–174PubMedGoogle Scholar
  28. 28.
    Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB (2005) Does total knee replacement restore normal knee function? Clin Orthop Relat Res 431:157–165CrossRefPubMedGoogle Scholar
  29. 29.
    Gandhi R, Tso P, Davey JR, Mahomed NN (2009) High-flexion implants in primary total knee arthroplasty: a meta-analysis. Knee 16:14–17CrossRefPubMedGoogle Scholar
  30. 30.
    Meneghini RM, Pierson JL, Bagsby D, Ziemba-Davis M, Berend ME, Ritter MA (2007) Is there a functional benefit to obtaining high flexion after total knee arthroplasty? J Arthroplasty 22:43–46CrossRefPubMedGoogle Scholar
  31. 31.
    Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN, Kinemax Outcomes Group (2003) Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplasty 18:286–294CrossRefPubMedGoogle Scholar
  32. 32.
    Park KK, Chang CB, Kang YG, Seong SC, Kim TK (2007) Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Jt Surg 89:604–608CrossRefGoogle Scholar
  33. 33.
    Minoda Y, Aihara M, Sakawa A, Fukuoka S, Hayakawa K, Ohzono K (2009) Range of motion of standard and high-flexion cruciate retaining total knee prostheses. J Arthroplasty 24:674–680CrossRefPubMedGoogle Scholar
  34. 34.
    Christen M, Aghayev E, Christen B (2014) Short-term functional versus patient-reported outcome of the bicruciate stabilized total knee arthroplasty: prospective consecutive case series. BMC Musculoskelet Disord 15:435CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • Alberto Vascellari
    • 1
    Email author
  • Stefano Schiavetti
    • 1
  • Enrico Rebuzzi
    • 1
  • Nicolò Coletti
    • 1
  1. 1.Orthopaedic and Traumatology DepartmentOderzo HospitalOderzoItaly

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