Association between limb alignment and patient-reported outcomes after total knee arthroplasty using an implant that reproduces anatomical geometry

Nakajima, Arata; Sonobe, Masato; Akatsu, Yorikazu; Aoki, Yasuchika; Takahashi, Hiroshi; Suguro, Toru; Nakagawa, Kōichi

doi:10.1186/s13018-018-1030-8

Cited by 32 publications

(23 citation statements)

References 25 publications

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“…All implants used in this study were the cruciate-retaining type FINE total knee (Teijin-Nakashima Medical, Okayama, Japan). Surgeries were performed according to our procedures published previously [19]. Briefly, osteophytes in the femorotibial and the patellofemoral joint were removed prior to cutting the distal femur and the proximal tibia, then distal femoral osteotomy was conducted perpendicular to the mechanical axis, and the posterior condyle was osteotomized parallel to the surgical epicondylar axis; a tibial osteotomy was subsequently conducted perpendicular to the anatomical axis of the tibia.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Toguchi

Nakajima

Akatsu

et al. 2020

BMC Musculoskelet Disord

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Background: Total knee arthroplasty (TKA) is the major surgical treatment for end-stage osteoarthritis (OA). Despite its effectiveness, there are about 20% of patients who are dissatisfied with the outcome. Predicting the surgical outcome preoperatively could be beneficial in order to guide clinical decisions. Methods: One-hundred and ten knees of 110 consecutive patients who underwent TKAs for varus knees resulting from OA were included in this study. Preoperative varus deformities were evaluated by femorotibial angle (FTA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), and classified as a severe varus (SV) or a mild varus (MV) group. The osteophyte score (OS), which we developed originally, was also calculated based on the size of the osteophytes and classified as groups with more or less osteophytes. We compared preoperative and 1year postoperative range of motion, the Knee Society Score, and Japanese Knee injury Osteoarthritis Outcome Score (KOOS) between SV and MV groups (varus defined by FTA, MPTA, or LDFA), in each group with more or less osteophytes. Results: When varus deformities were defined by FTA, regardless of OS, postoperative KOOS subscales and/or the improvement rates were significantly higher in the SV group than in the MV group. When varus defined by MPTA, regardless of OS, there were no significant differences in postoperative KOOS subscales between groups. However, when varus defined by LDFA, scores for pain, activities of daily living (ADL), and quality of life (QOL) on postoperative KOOS and/or the improvement rates were significantly higher in the SV group than in the MV group only in patients with less osteophytes. No significant differences were found between groups in patients with more osteophytes. Conclusions: We classified OA types by radiographic measurements of femur and tibia in combination with OS. Postoperative patient-reported outcomes were better in patients with SV knees but were poor in patients with knees with MV deformity and less osteophytes.

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Section: Surgical Proceduresmentioning

confidence: 99%

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Toguchi

Nakajima

Akatsu

et al. 2020

BMC Musculoskelet Disord

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“…All TKAs were performed using the measured resection technique by anterior reference [ 18 ]. Surgical approaches were chosen either mid-vastus or sub-vastus for varus knees, but the lateral parapatellar approach was used for valgus knees.…”

Section: Methodsmentioning

confidence: 99%

Three-year clinical and radiological results of a cruciate-retaining type of the knee prosthesis with anatomical geometry developed in Japan

Nakajima

Yamada

Sonobe

et al. 2021

BMC Musculoskelet Disord

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Background The FINE total knee was developed in Japan and clinical use began in 2001. It has unique design features, including an oblique 3o femorotibial joint line that reproduces anatomical geometry. Although 20 years have passed since the FINE knee was clinically used for the first time in Japan, a formal clinical evaluation including patient-reported and radiographic outcomes has not been undertaken. Methods A total of 175 consecutive primary cruciate-retaining (CR)-FINE total knee arthroplasties (TKAs) at our hospital between February 2015 and March 2017 were included in this study. Three years postoperatively, range of motion (ROM), Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Forgotten Joint Score (FJS) were recorded and compared with preoperative scores. Radiographic analyses including mechanical alignment, component alignment, and incidence of radiolucent lines also were undertaken based on the radiographs 3 years postoperatively. Results One-hundred twenty-two knees (70%) were available for 3-year follow-up data using KOOS, except for the sports subscale. Postoperative KOOS-symptom, −pain and -ADL were > 85 points, but KOOS-sports, −QOL and FJS were less satisfactory. ROM, KSS and all the subscales of KOOS were significantly improved compared with preoperative scores. Postoperative mean FJS was 66 and was significantly correlated with all the subscales of KOOS, but not with postoperative ROM. Radiolucent lines ≧1 mm wide were detected in five knees (4.1%). There were no major complications needing revision surgeries. Conclusions Patient-reported outcomes (PROs) for symptoms, pain and ADL after the CR-FINE TKA were generally improved, but those for sports, QOL and FJS were improved less. The incidence of radiolucent lines was rare but detected around the femoral components. With the mid- to long-term follow-up, improvements of surgical technique will be necessary to achieve better PROs from patients receiving the FINE knee.

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“…All TKAs were performed using the measured resection technique by anterior reference (15). Surgical approaches were chosen either mid-vastus or sub-vastus for varus knees, but the lateral parapatellar approach was used for valgus knees.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Three-Year Clinical Results of a Cruciate-Retaining Type of the Knee Prosthesis with Anatomical Geometry Developed in Japan

Nakajima¹,

Sonobe²,

Akatsu³

et al. 2020

Preprint

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Background: The FINE total knee was developed in Japan and clinical use began in 2001. It has unique design features, including an oblique 3o femorotibial joint line that reproduces anatomical geometry. Although 20 years have passed since the FINE knee was clinically used for the first time in Japan, a formal clinical evaluation including patient-reported and radiographic outcomes has not been undertaken.Methods: A total of 175 consecutive primary cruciate-retaining (CR)-FINE total knee arthroplasties (TKAs) at our hospital between February 2015 and March 2017 were included in this study. Three years postoperatively, range of motion (ROM), Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Forgotten Joint Score (FJS) were recorded and compared with preoperative scores. Radiographic analyses including mechanical alignment, component alignment, and incidence of radiolucent lines also were undertaken based on the radiographs three years postoperatively.Results: One-hundred twenty-two knees (70%) were available for 3-year follow-up data using KOOS, except for the sports subscale. Postoperative KOOS-symptom, -pain and -ADL were > 85 points, but KOOS-sports, -QOL and FJS were less satisfactory. ROM, KSS and all the subscales of KOOS were significantly improved compared with preoperative scores. Postoperative mean FJS was 66 and was significantly correlated with all the subscales of KOOS, but not with postoperative ROM. Radiolucent lines ≧1 mm wide were detected in five knees (4.1%). There were no major complications needing revision surgeries.Conclusions: Patient-reported outcomes (PROs) for symptoms, pain and ADL after the CR-FINE TKA were generally improved, but those for sports, QOL and FJS were improved less. The incidence of radiolucent lines was rare but detected around the femoral components. Improvements of surgical technique or innovation of the implant design with mid- to long-term follow-up will be necessary to achieve better PROs from patients receiving the FINE knee.

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Association between limb alignment and patient-reported outcomes after total knee arthroplasty using an implant that reproduces anatomical geometry

Cited by 32 publications

References 25 publications

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

Three-year clinical and radiological results of a cruciate-retaining type of the knee prosthesis with anatomical geometry developed in Japan

Three-Year Clinical Results of a Cruciate-Retaining Type of the Knee Prosthesis with Anatomical Geometry Developed in Japan

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