Intraoperative passive kinematics of osteoarthritic knees before and after total knee arthroplasty

Siston, Robert A.; Giori, Nicholas J.; Goodman, Stuart B.; Delp, Scott L.

doi:10.1002/jor.20163

Cited by 84 publications

(141 citation statements)

References 53 publications

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“…An increase in anterior femoral translation after TKA has been welldocumented [12,16,45,55], with Cromie et al [16] reporting TKA knees showed a mean of 16.1 mm anterior motion, which overlaps with our findings (Table 2). Studies on tibial internal-external rotation after TKA have reported mixed findings, with some researchers noting decreases [45] and others reporting no change [12].…”

Section: Discussionsupporting

confidence: 90%

“…This system, along with previous systems created by the senior author (RAS), has been validated and successfully used previously [16,45,46,48]. Specimens with severe osteoarthritis, prior fractures, damaged soft tissues, or other abnormalities were not included.…”

Section: Methodsmentioning

confidence: 99%

“…After the knee was exposed, passive optical maker arrays with four reflective spheres were attached to the femur and tibia and anatomic reference frames were established [45]. The greater trochanter, the distal femur, the proximal tibia, and the malleoli were digitized to register the specimen to the CT data using an iterative closest-point algorithm [7].…”

mentioning

confidence: 99%

“…To measure passive kinematics, the skin surrounding the knee was closed with two to three towel clips and the joint was flexed by supporting the foot with an open palm while gently lifting the thigh [45]. The reverse procedure was used to extend the knee.…”

mentioning

confidence: 99%

“…translation of the femur on the tibia [16], and internalexternal rotation of the tibia between 5°and 105°flexion [45].…”

mentioning

confidence: 99%

See 4 more Smart Citations

Is There a Gold Standard for TKA Tibial Component Rotational Alignment?

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Clinical Orthopaedics &Amp; Related Research

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…translation of the femur on the tibia [16], and internalexternal rotation of the tibia between 5°and 105°flexion [45].…”

mentioning

confidence: 99%

See 3 more Smart Citations

Is There a Gold Standard for TKA Tibial Component Rotational Alignment?

Hutter

Granger

Beal

et al. 2013

Clinical Orthopaedics &Amp; Related Research

Self Cite

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Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty

Cromie

Siston

Giori

et al. 2008

Journal Orthopaedic Research

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Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20–60°) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1±4.3 mm to 10.4±5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2±9.6° to 49.3±7.3°). Implanting the prosthesis increased the amount of anterior translation (to 16.1±4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0–60°) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis.

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Knee stability before and after total and unicondylar knee replacement: In vivo kinematic evaluation utilizing navigation

Casino

Martelli

Zaffagnini

et al. 2008

Journal Orthopaedic Research

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Surgical navigation systems are currently used to guide the surgeon in the correct alignment of the implant. The aim of this study was to expand the use of navigation systems by proposing a surgical protocol for intraoperative kinematics evaluations during knee arthroplasty. The protocol was evaluated on 20 patients, half undergoing unicondylar knee arthroplasty (UKA) and half undergoing posterior-substituting, rotating-platform total knee arthroplasty (TKA). The protocol includes a simple acquisition procedure and an original elaboration methodology. Kinematic tests were performed before and after surgery and included varus/valgus stress at 0 and 308 and passive range of motion. Both UKA and TKA improved varus/valgus stability in extension and preserved the total magnitude of screw-home motion during flexion. Moreover, compared to preoperative conditions, values assumed by tibial axial rotation during flexion in TKA knees were more similar to the rotating patterns of UKA knees. The analysis of the anteroposterior displacement of the knee compartments confirmed that the two prostheses did not produce medial pivoting, but achieved a postoperative normal behavior. These results demonstrated that proposed intraoperative kinematics evaluations by a navigation system provided new information on the functional outcome of the reconstruction useful to restore knee kinematics during surgery. ß

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Intraoperative passive kinematics of osteoarthritic knees before and after total knee arthroplasty

Cited by 84 publications

References 53 publications

Is There a Gold Standard for TKA Tibial Component Rotational Alignment?

Is There a Gold Standard for TKA Tibial Component Rotational Alignment?

Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty

Knee stability before and after total and unicondylar knee replacement: In vivo kinematic evaluation utilizing navigation

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