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The higher patient-reported outcome measure group had smaller external rotation of the femur in bicruciate-stabilized total knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The hypothesis of this study was that the kinematics of patients with higher patient-reported outcome measures (PROMs) differ from those of patients with lower PROMs after bicruciate-stabilized total knee arthroplasty (BCS-TKA).

Methods

A total of 32 patients with severe knee osteoarthritis were examined 11.2 ± 3.2 months after BCS-TKA. The patients performed squats under single fluoroscopic surveillance in the sagittal plane. To estimate the spatial position and orientation of the femoral and tibial components, a 2D-to-3D registration technique was used. This technique uses a contour-based registration algorithm, single-view fluoroscopic images and 3D computer-aided design models. Knee range of motion, varus–valgus alignment, axial rotation of the femur relative to the tibial component, anteroposterior translation of the medial and lateral femorotibial contact points, kinematic paths, and anterior and posterior post-cam engagement were measured. The patients were divided into two groups using hierarchical cluster analysis based on the 1-year postoperative Knee Injury and Osteoarthritis Outcome Score and 2011 Knee Society Score.

Results

The femoral component had significantly more external rotation in the low-score group than in the high-score group (5.1 ± 1.8° vs. 2.2 ± 2.7°, p = 0.02). The high-score group had a medial pivot pattern from 0 to 20° of flexion, without significant movement from 20 to 70°, and final bicondylar rollback beyond 70°. The low-score group had a medial pivot from 0 to 70° of flexion and bicondylar rollback beyond 70°. There were no significant between-group differences in the varus–valgus angle or post-cam engagement.

Conclusion

The higher PROM group had smaller external rotation of the femur after BCS-TKA.

Level of evidence

Level III.

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Funding

No funding was received for the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Kenichi Kono, Hiroshi Inui, Shuji Taketomi, Ryota Yamagami, Kohei Kawaguchi & Sakae Tanaka

  2. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan

    Kenichi Kono & Tetsuya Tomita

  3. Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, Saitama, Japan

    Takaharu Yamazaki

Authors
  1. Kenichi Kono
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  2. Hiroshi Inui
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  3. Tetsuya Tomita
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  4. Takaharu Yamazaki
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  5. Shuji Taketomi
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  6. Ryota Yamagami
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  7. Kohei Kawaguchi
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  8. Sakae Tanaka
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Contributions

Kenichi Kono helped perform the study and formal analysis and write the manuscript. Hiroshi Inui carried out data curation and conceived the study. Takaharu Yamazaki, Ryota Yamagami, and Kohei Kawaguchi provided technical assistance. Tetsuya Tomita, Shuji Taketomi, and Sakae Tanaka provided general support. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiroshi Inui.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the University of Tokyo Institutional Ethics Review Board (number 10462-(1)).

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Informed consent was obtained from all individual participants included in the study.

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The patients signed informed consent forms for the publication of their data and photographs.

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Kono, K., Inui, H., Tomita, T. et al. The higher patient-reported outcome measure group had smaller external rotation of the femur in bicruciate-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 30, 1292–1299 (2022). https://doi.org/10.1007/s00167-021-06577-w

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  • DOI: https://doi.org/10.1007/s00167-021-06577-w

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