Changes in Femoral Posterior Condylar Offset, Tibial Posterior Slope Angle, and Joint Line Height after Cruciate-Retaining Total Knee Arthroplasty

Song, Sang Jun; Bae, Dae Kyung; Kim, Kang‐Il; Jeong, Ho Yeon

doi:10.5792/ksrr.2016.28.1.27

Cited by 12 publications

(17 citation statements)

References 27 publications

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“…16,17,25,26 There are also studies showing that the PCO is not associated with the postoperative maximal flexion angles. 18,21,[27][28][29] For example, Bellemans et al 17 and Massin and Gournay 26 indicated that reducing the PCO Fig. 3 Correlations of the changes of (A) the posterior condyle offset (PCO) and (B) the PCO ratio (PCOR) with the changes of maximal knee flexion after the cruciate retaining (CR) total knee arthroplasty (TKA); correlations of the changes of (c) the PCO and (d) the PCOR with the changes of the posterior cruciate ligament (PCL) elongation at the maximal flexion angles of the knee after the CR TKA.…”

Section: Discussionmentioning

confidence: 99%

“…The relative positions of the PCL attachment areas on the tibia and femur of the OA knees and TKA knees were also determined at each flexion angle. 32 Using the pre-and postoperative knee models, the femoral PCO was determined in a sagittal plane [16][17][18][19][20][21][22][23][24] (►Fig. 2A).…”

Section: Description Of Experiment Treatment or Surgerymentioning

confidence: 99%

“…Many studies have investigated the correlation between the femoral posterior condyle offset (PCO) and the maximal knee flexion using sagittal plane X-ray or computed tomography (CT) images of the knee before and after TKAs, but with inconsistent conclusions. [16][17][18][19][20][21][22][23][24] From a biomechanical point of view, an increase of PCO could increase the posterior tibiofemoral space in flexed knee positions and therefore minimize the posterior tibiofemoral impingement. This mechanism was thought to enhance the capability of deep knee flexion.…”

mentioning

confidence: 99%

“…17 While some studies did show that the change of PCO after TKA is correlated to the postoperative knee flexion, 16,17,25,26 there are studies that do not show a correlation. 18,21,24,[27][28][29] Recently, a patient study found that the femoral condyle heights were significantly increased at weight-bearing maximal flexion angles of the knee after TKA when compared with the preoperative knees. 30 Since increased condyle height could cause tightness of the knee and affect knee flexion capability 30 and since the PCO is directly related to the femoral condyle height, we hypothesize that an increase of the PCO after TKA could limit the postoperative maximal flexion of the knee.…”

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confidence: 99%

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Posterior Condyle Offset and Maximum Knee Flexion Following a Cruciate Retaining Total Knee Arthroplasty

et al. 2018

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Inconsistent data has been reported on the effect of the femoral posterior condyle offset (PCO) on the maximal knee flexion after total knee arthroplasty (TKA). This study investigated the relationship between the postoperative changes of the PCO and the changes of maximal knee flexion after a cruciate retaining (CR) TKA. Nine patients with medial osteoarthritis (OA) in one knee were investigated. Before operation, each index knee was magnetic resonance imaging (MRI) scanned for construction of a three-dimensional (3D) knee model. The patient then performed a maximal weight-bearing (WB) flexion and the index knee flexion was measured using a dual fluoroscopy technique. At an average of 8 months after a CR TKA, all patients performed the same WB knee flexion. The postoperative changes of the PCO, the posterior cruciate ligament (PCL) elongation, and the posterior tibial slope (PTS) were determined. The postoperative changes of maximal knee flexion were determined by comparing with the preoperative maximal flexion angles of the knee. The correlations of the postoperative changes of PCO and PTS with the postoperative changes of the maximal flexion angle and PCL elongation of the knee were analyzed. The preoperative PCO (28.5 ± 4.5 mm) was significantly smaller than the postoperative PCO (31.1 ± 5.1 mm) ( < 0.05). The increasing of PCO after surgery is correlated with the decreasing of maximal knee flexion angle ( = 0.74) and the increasing of PCL elongation ( = 0.64) after the TKA. The PTS was not found to change significantly after the TKA and was not significantly correlated to the maximal knee flexion angle and PCL elongation. The postoperative increases of the PCO were shown to cause overstretching of the PCL and poor flexion angle of the knee after the CR TKA. Restoration of PCO could help optimize the maximal flexion of the knee after the TKA with consideration about PCL tension.

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Section: Discussionmentioning

confidence: 99%

Section: Description Of Experiment Treatment or Surgerymentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Posterior Condyle Offset and Maximum Knee Flexion Following a Cruciate Retaining Total Knee Arthroplasty

et al. 2018

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“…The findings of this study should be interpreted with several limitations. First, there is a variety of different methods reported in the literature for the measurement of JLE, 35,41,46,51 which may have affected the study findings. However, the method for the measurement of JLE as used in this study has also been used in multiple published reports.…”

Section: Limitationsmentioning

confidence: 99%

The Effect of Joint Line Elevation on In Vivo Knee Kinematics in Bicruciate Retaining Total Knee Arthroplasty

et al. 2021

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Prior studies have reported a negative effect on both clinical outcomes and patient-reported outcome measures (PROMS) following joint line elevation (JLE) in cruciate-retaining (CR) total knee arthroplasty (TKA) and posterior stabilized (PS) TKA designs. This experimental study was aimed to quantify the effect of JLE on in vivo knee kinematics in patients with bicruciate retaining (BCR) TKA during strenuous activities. Thirty unilateral BCR TKA patients were evaluated during single-leg deep lunge and sit-to-stand using a validated combined computer tomography and dual fluoroscopic imaging system. Correlation analysis was performed to quantify any correlations between JLE and in vivo kinematics, as well as PROMS. There was a significant negative correlation between JLE and maximum flexion angle during single-leg deep lunge (ρ = −0.34, p = 0.02), maximum varus joint angles during single-leg deep lunge (ρ = −0.37, p = 0.04), and sit-to-stand (ρ = −0.29, p = 0.05). There was a significant negative correlation between JLE and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (ρ = −0.39, p = 0.01) and knee disability and osteoarthritis outcome score physical function (KOOS-PS; ρ = −0.33, p = 0.03). The JLE that yields a significant loss in PROMS and maximum flexion angles were 2.6 and 2.3 mm, respectively. There was a linear negative correlation of JLE with both in vivo knee kinematics and PROMS, with changes in JLE of greater than 2.6 and 2.3 mm, leading to a clinically significant loss in PROMS and maximum flexion angles, respectively, suggesting an increased need to improve surgical precision to optimize patient outcomes following BCR TKA.

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Basics of 2D Planning in Total Knee Replacement

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Abermann

2020

ESSKA Instructional Course Lecture Book

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Changes in Femoral Posterior Condylar Offset, Tibial Posterior Slope Angle, and Joint Line Height after Cruciate-Retaining Total Knee Arthroplasty

Cited by 12 publications

References 27 publications

Posterior Condyle Offset and Maximum Knee Flexion Following a Cruciate Retaining Total Knee Arthroplasty

Posterior Condyle Offset and Maximum Knee Flexion Following a Cruciate Retaining Total Knee Arthroplasty

The Effect of Joint Line Elevation on In Vivo Knee Kinematics in Bicruciate Retaining Total Knee Arthroplasty

Basics of 2D Planning in Total Knee Replacement

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