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Intra-operative gaps affect outcome and postoperative kinematics in vivo following cruciate-retaining total knee arthroplasty

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Abstract

Purpose

The following investigation evaluates the effect of intra-operative gaps after posterior cruciate ligament-retaining total knee arthroplasty using two-dimensional/three-dimensional registration and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Methods

Patients were divided into two groups according to their 90°-0° component gap changes using a device designed by our laboratory. The wide gap group was defined as more than 3 mm (4.3 ± 0.7 mm), and the narrow gap group was defined as less than 3 mm (1.3 ± 1.3 mm).

Results

Under non-WB (weight bearing) conditions, the wide flexion gap group (N = 10) showed a significant anterior displacement of the medial femoral condyle as compared with the narrow flexion gap group (N = 20). Despite no significant differences observed under WB conditions, both femoral condyle positions during flexion were significantly more posterior than during extension. WOMAC of the tight gap group showed worse scores for two functional items demanding knee flexion (bending to floor and getting on/off toilet).

Conclusion

The large flexion gap could influence the late rollback under non-WB conditions and better WOMAC functional scores in the flexion items. Three to four millimetre laxity at 90°–0° component gaps may be adequate and might be necessary to carry out daily life activities.

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Acknowledgments

The authors would like to thank Kenji Iwami and Takeshi Fujii for their invaluable assistance with the photography.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Chugoku Rousai Hospital, 1-5-1 Hirotagaya, Kure, Hiroshima, 737-0193, Japan

    Eisaku Fujimoto, Yoshiaki Sasashige, Hirofumi Sasaki, Yoriko Touten & Yuusuke Fujiwara

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

    Tetsuya Tomita

  3. Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan

    Mitsuo Ochi

Authors
  1. Eisaku Fujimoto
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  2. Yoshiaki Sasashige
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  3. Tetsuya Tomita
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  4. Hirofumi Sasaki
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  5. Yoriko Touten
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  6. Yuusuke Fujiwara
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  7. Mitsuo Ochi
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Corresponding author

Correspondence to Eisaku Fujimoto.

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Fujimoto, E., Sasashige, Y., Tomita, T. et al. Intra-operative gaps affect outcome and postoperative kinematics in vivo following cruciate-retaining total knee arthroplasty. International Orthopaedics (SICOT) 40, 41–49 (2016). https://doi.org/10.1007/s00264-015-2847-y

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  • DOI: https://doi.org/10.1007/s00264-015-2847-y

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