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

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

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.

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References

  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 466:2669–2676

    Article  PubMed  PubMed Central  Google Scholar 

  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 26:178–186

    Article  PubMed  Google Scholar 

  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 460:174–177

    CAS  PubMed  Google Scholar 

  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 404:172–188

    Article  PubMed  Google Scholar 

  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):936–942

    Article  PubMed  Google Scholar 

  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 93:907–913

    Article  CAS  PubMed  Google Scholar 

  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 468:19–28

    Article  PubMed  PubMed Central  Google Scholar 

  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):2002–2010

    Article  PubMed  Google Scholar 

  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 468:807–814

    Article  PubMed  PubMed Central  Google Scholar 

  10. Brilhault J, Ries MD (2010) Measuring patellar height using the lateral active flexion radiograph: effect of total knee implant design. Knee 17:148–151

    Article  PubMed  Google Scholar 

  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 27:1569–1575

    Article  PubMed  Google Scholar 

  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 36:1589–1593

    Article  PubMed  PubMed Central  Google Scholar 

  13. Noble JW Jr, Moore CA, Liu N (2012) The value of patient matched instrumentation in total knee arthroplasty. J Arthroplasty 27:153–155

    Article  PubMed  Google Scholar 

  14. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  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 20:330–335

    Article  CAS  Google Scholar 

  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 2:150–166

    Article  CAS  PubMed  Google Scholar 

  17. Edwards JZ, Greene KA, Davis RS, Kovacik MW, Noe DA, Askew MJ (2004) Measuring flexion in knee arthroplasty patients. J Arthroplasty 19:369–372

    Article  PubMed  Google Scholar 

  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 19:1693–1698

    Article  CAS  PubMed  Google Scholar 

  19. Evans JD (1996) Straightforward statistics for the behavioral sciences. Brooks/Cole Publishing, Pacific Grove

    Google Scholar 

  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 22:581–589

    Article  PubMed  Google Scholar 

  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 25:249–253

    Article  PubMed  Google Scholar 

  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 468:1214–1220

    Article  PubMed  PubMed Central  Google Scholar 

  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 94:1051–1057

    Article  CAS  PubMed  Google Scholar 

  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 84:50–53

    Article  CAS  PubMed  Google Scholar 

  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 17:491–498

    Article  PubMed  Google Scholar 

  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 12:143–155

    Article  CAS  PubMed  Google Scholar 

  27. Tew M, Forster IW, Wallace WA (1989) Effect of total knee arthroplasty on maximal flexion. Clin Orthop Relat Res 247:168–174

    PubMed  Google Scholar 

  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 431:157–165

    Article  PubMed  Google Scholar 

  29. Gandhi R, Tso P, Davey JR, Mahomed NN (2009) High-flexion implants in primary total knee arthroplasty: a meta-analysis. Knee 16:14–17

    Article  PubMed  Google Scholar 

  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 22:43–46

    Article  PubMed  Google Scholar 

  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 18:286–294

    Article  PubMed  Google Scholar 

  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 89:604–608

    Article  CAS  Google Scholar 

  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 24:674–680

    Article  PubMed  Google Scholar 

  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 15:435

    Article  PubMed  PubMed Central  Google Scholar 

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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.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Department, Oderzo Hospital, Via Luzzatti 33, 31046, Oderzo, Treviso, Italy

    Alberto Vascellari, Stefano Schiavetti, Enrico Rebuzzi & Nicolò Coletti

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  1. Alberto Vascellari
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  2. Stefano Schiavetti
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Correspondence to Alberto Vascellari.

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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.

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Vascellari, A., Schiavetti, S., Rebuzzi, E. et al. Functional versus patient-reported outcome of the bicruciate and the standard condylar-stabilizing total knee arthroplasty. Eur J Orthop Surg Traumatol 26, 305–310 (2016). https://doi.org/10.1007/s00590-016-1750-6

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  • DOI: https://doi.org/10.1007/s00590-016-1750-6

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