Is Single-Radius Design Better for Quadriceps Recovery in Total Knee Arthroplasty?

Kim, Duk Hyun; Kim, Dong Kyoon; Lee, Sang Hak; Kim, Kang‐Il; Bae, Dae Kyung

doi:10.5792/ksrr.2015.27.4.240

Cited by 14 publications

(21 citation statements)

References 27 publications

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“…We identified 595 articles initially through both online and manual searches undertaken up to February 2020. After we applied the exclusion criteria, ultimately nine RCTs remained to be analyzed in this meta-analysis [14,[19][20][21][22][23][24][25][26] (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Kim

Min

Lee³

et al. 2020

Knee Surg & Relat Res

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Purpose Our purpose in the current meta-analysis was to compare the functional outcomes in patients who have received single-radius (SR) or multi-radius (MR) femoral components in randomized controlled trials (RCTs) for primary total knee arthroplasty (TKA). The hypothesis was that there would be no statistically significant difference between two groups in terms of functional outcomes. Materials and methods We searched the international electronic databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to February 2020 for RCTs that compared functional outcomes of SR and MR femoral component designs after primary TKA. We performed a meta-analysis of nine RCTs using the Knee Society Score for the knee (KSS-knee), KSS-function, Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), degree of knee flexion, extension, and complications, including postoperative infection and revision surgery. Results The meta-analysis revealed no statistically significant differences in all the analyzed variables, including KSS-knee, KSS-function, KOOS, OKS, knee flexion, and knee extension. For postoperative complications, no statistically significant differences were detected for femoral component designs in postoperative infection or incidence of revision surgery between the two groups. Conclusions The current meta-analysis of RCTs did not show any statistically significant differences between SR and MR femoral component designs in terms of postoperative functional outcomes. Evaluated outcomes included functional outcome scores, degree of knee flexion, extension, and complications. However, because of the limited clinical evidence of this study owing to the heterogeneity between the included RCTs, a careful approach should be made in order not to arrive at definite conclusions.

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Section: Resultsmentioning

confidence: 99%

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Kim

Min

Lee³

et al. 2020

Knee Surg & Relat Res

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“…Wang et al [12] reported that a prolonged duration was required in patients undergoing the MR design to perform the sit-to-stand test than those undergoing the SR design as assessed by 3-dimensional kinematics. Larsen et al [17] and Kim et al [19] reported higher extensor strength in SR knees than that in their MR counterparts. Although SR protheses showed better results in [21] conducted an isokinetic study and observed better extensor performance with decreased flexion peak torque and increased extension peak torque in patients with SR design than those with MR design.…”

Section: Discussionmentioning

confidence: 94%

“…Clinical studies that compared the SR and MR femoral design yielded contradictory results [14][15][16][17][18][19]. Liu et al conducted a meta-analysis in order to find the difference in clinical outcomes between the SR and MR femoral design.…”

Section: Introductionmentioning

confidence: 99%

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Zhang

et al. 2020

Arthroplasty

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Background: Strength deficits, muscle imbalances, and quadriceps inhibition are common after the total knee arthroplasty (TKA). It was suggested that theoretically single radius (SR) femoral protheses could provide longer extensor moment arm compared to the multiple radius (MR) design. However, quantitative evidence has not yet been reported. Thus, the aim of the study was to investigate the differences in isokinetic data and to compare the patient-reported outcome scores between TKA SR and MR design. Method: The present retrospective study included 36 TKA involving 16 knees (9 patients) using SR design implant and 20 knees (11 patients) using MR design implant. The mean follow-up time was longer than 1 year. Isokinetic knee flexion and extension torques of the operated leg were evaluated at 60°/s and 180°/s. Quadriceps and hamstring torques and ratios, work and power were recorded. Angle-specific torques were also collected at different extension or flexion angles. Results: Both groups showed improvement in knee society scores (KSS) and knee injury, and osteoarthritis outcome score (KOOS) after operation. Patients in SR group had significantly higher scores in KSS-knee, symptoms and activities of daily living KOOS sub-score than those in the MR group at the end of the follow-up. The peak knee flexion torque, peak knee extension torque and maximum knee flexion work were greater in SR group at 180°/s and 60°/s. At 60°/s, and SR group had higher average knee flexion power and average knee extension power than MR group. In the isometric contraction test, the knee extension torque was higher in SR group than in MR group. At 180°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°compared with MR group. At 60°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°, 80°when compared with MR group. Additionally, SR group also provided higher extension torques at 40°, 50°, 60°than the MR group. There were no differences in other isokinetic and isometric parameters between the two groups. Conclusion: Femoral design exerted an influence on quadriceps and hamstring strength after TKA, and SR design shows advantages, in terms of higher extension and flexion strength, over MR design.

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“…Traditionally, knee prosthetics with multi-radius design over the femoral component have been used; however, recent development of single-radius knee implants have shown improvements in both mechanical and clinical functions of the knee after TKA [8,13,14,18,[26][27][28][29][30]. In these implants, the biomechanical functions are improved by lengthening the extensor moment arm, providing longer distal and posterior axis, and by maintaining the isometry of the rotation and force distribution throughout the range of motion resulting in less patellar load [7,8,31,32].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Functional Outcomes of Total Knee Arthroplasty Using Two Different Single Radius Implants

Pourmoghaddam¹,

Dettmer²,

Malanka³

et al. 2016

ReconRev

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Total knee arthroplasty is used as the treatment plan for patients with end-stage osteoarthrosis associated with severely affected function. Although TKA has been used for many years, some patients have reported overall dissatisfaction regarding the outcome. This may be due to the complexity of the joint design. In recent years, the concept of single-radius knee prosthetics is gaining more popularity as many studies have discussed biomechanical and clinical benefits of such design compared to traditionally used multi-radius implants. In this study, we report the outcome of 78 patients who were treated by TKA utilizing a relatively new single-radius implant, Unity. Results showed that all subjects reported good outcomes as expressed by significant improvement in their Knee Injury and Osteoarthritis Outcome Scores at 1-year post-operative. The symptom, pain, and ADL subscores demonstrated significant improvement in patients with scores twice the pre-operative value, while the average improvement in sport and quality of life subscores showed even greater improvement with scores three times the pre-operative value.

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Is Single-Radius Design Better for Quadriceps Recovery in Total Knee Arthroplasty?

Cited by 14 publications

References 27 publications

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Comparison of Functional Outcomes of Total Knee Arthroplasty Using Two Different Single Radius Implants

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