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Intraoperative kinematic analysis of posterior stabilized total knee arthroplasty with asymmetric helical post-cam design

  • Original Article • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To investigate intraoperative kinematics during passive flexion using a surgical navigation system for knees undergoing posterior stabilized (PS) total knee arthroplasty (TKA) with an asymmetric helical post-cam design using navigation system.

Methods

In total, 45 knees with both pre- and postoperative kinematic data available were included in the study. Intraoperative kinematic measurements were performed during the course of surgery using the software incorporated in the navigation system. Measurements were performed at the following two time points: (1) before TKA procedure and (2) after TKA implantation. Among the kinematic parameters studied, anterior/posterior translation and axial rotation during flexion were subjected to the analysis.

Results

Before surgery, physiologic anterior/posterior translational pattern of the tibia during flexion (rollback of the femur) was found in only 15.6% of the knees. After TKA implantation, postoperative kinematic measurement showed no significant change in the tibial translational during knee flexion. Similarly, with regard to rotation, non-physiologic external tibial rotation in early flexion was observed in the majority of the knees before surgery, and this abnormal kinematic pattern remained after the TKA procedure.

Conclusions

The intraoperative three-dimensional motion analysis using a navigation system showed that the physiologic kinematic pattern (anterior translation and internal rotation of the tibia during flexion) of the knee was distorted in osteoarthritic knees undergoing TKA. The abnormal kinematic pattern before surgery was not fully corrected even after implantation of the PS TKA designed to induce natural knee motion; however, no clear relationship between the intraoperative kinematic pattern and knee flexion angle at one year was demonstrated, and the effect of knee kinematics on postoperative knee function and patient’s satisfaction is still unclear.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan

    Takatoshi Morooka, Makiko Okuno, Daisuke Seino, Takuya Iseki, Shigeo Fukunishi & Shinichi Yoshiya

  2. Graduate School of Engineering, University of Hyogo, 2167 Syosya, Himeji, Hyogo, 671-2280, Japan

    Syoji Kobashi

Authors
  1. Takatoshi Morooka
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  2. Makiko Okuno
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  3. Daisuke Seino
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  4. Takuya Iseki
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  5. Shigeo Fukunishi
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  6. Syoji Kobashi
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  7. Shinichi Yoshiya
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Correspondence to Takatoshi Morooka.

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

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and later amendments or comparable ethical standards.

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Morooka, T., Okuno, M., Seino, D. et al. Intraoperative kinematic analysis of posterior stabilized total knee arthroplasty with asymmetric helical post-cam design. Eur J Orthop Surg Traumatol 29, 675–681 (2019). https://doi.org/10.1007/s00590-018-2318-4

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  • DOI: https://doi.org/10.1007/s00590-018-2318-4

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