Measurement of rotational and coronal alignment in total knee arthroplasty using a navigation system is reproducible

Wada, Keizo; Mikami, Hiroshi; Hamada, Daisuke; Yonezu, Hiroshi; Oba, Koichi; Sairyo, Koichi

doi:10.1007/s00402-015-2402-8

Cited by 17 publications

(14 citation statements)

References 25 publications

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“…Third, the reproducibility of the kinematic analysis was not evaluated, except for the rotational kinematics ; however, this may be questionable because the analysis was performed manually. Nevertheless, in a previous study, Wada et al demonstrated that intraoperative analysis of kinematics was highly reproducible (9). Therefore, we believe that our present data, which were obtained using the same method, have acceptable reproducibility.…”

Section: Discussionsupporting

confidence: 59%

“…Several studies have focused on the kinematics of the knee after TKA (6,7). With increasingly widespread use of navigation systems, the kinematics of the knee have been evaluated in more detail (8,9). However, some reports have claimed that anterior-posterior translation of the femur cannot be assessed directly using a navigation system, citing this problem as a limitation of navigation technology (10,11).…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study

et al. 2019

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The aim of this cadaveric study was to evaluate the intraoperative kinematics of the native knee including two-dimensional translation of the femur using a navigation system. Eight native knees of 4 fresh-frozen whole-body cadavers were used for the study. The kinematics of each knee were analyzed intraoperatively using the navigation system. Although anterior-posterior translation could not be assessed directly, it could be calculated using a formula derived from the parameters in the navigation system. The native knee showed external rotation of the femur in early knee flexion, transient internal rotation in mid flexion, and gradual external rotation in late flexion. There was no marked change in the coronal rotation angle of the mechanical axis during knee flexion. The femoral center moved anteriorly in early knee flexion and posteriorly in late flexion. The distance moved in the medial-lateral direction was relatively smaller than that in the anterior-posterior direction. Two-dimensional translation of the surgical epicondylar axis showed a medial pivot-like motion. In this cadaveric study, the kinematics of the native knee, including two-dimensional translation of the femur, could be satisfactorily assessed intraoperatively using a navigation system. The intraoperative kinematics of the knee can be analyzed in more detail using this methodology.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study

et al. 2019

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“…Nevertheless, in a previous study, Wada et al demonstrated that intraoperative analysis of kinematics was highly reproducible. 10 Therefore, we believe that our present data, which were obtained using the same method, have acceptable reproducibility. Third, the mean age of knees included in this study is 82.8 years, which is relatively old for studies of normal knees.…”

Section: Discussionsupporting

confidence: 57%

Rotational and varus–valgus laxity affects kinematics of the normal knee: A cadaveric study

Wada

Hamada

Takasago

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: The aim of this study was to evaluate the relationship between soft tissue laxity and kinematics of the normal knee using a navigation system. Methods: Fifteen cadaveric knees from 11 fresh frozen whole-body specimens were included in this study. The navigation system automatically recorded the rotation angle of the tibia as the internal–external (IE) kinematics and the coronal alignment of the lower limb as the varus–valgus (VV) kinematics. These measurements were made with the joint in maximal extension, at 10° intervals from 0° to 120° of flexion, and at maximal flexion during passive knee motion. For evaluation of laxity, the examiner gently applied maximum manual IE and VV stress to the knee at 0°, 30°, 60°, and 90° of flexion. Results: The measurements showed almost perfect reliability. The mean correlation coefficient between the intraoperative tibial rotation angle and the intermediate angle of IE laxity was 0.82, while that between the coronal alignment of the lower limb and the intermediate angle of the VV laxity was 0.96. There was a statistically significant correlation between kinematics and laxity at all degrees of knee flexion. Conclusion: The present study revealed that the rotation angle of the tibia was correlated to the intermediate angle of IE laxity at 0°, 30°, 60°, and 90° of knee flexion and the coronal alignment of the lower limb also correlated to the intermediate angle of VV laxity. These findings provide important reference data on soft tissue laxity and kinematics of the normal knee.

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“…Most previous studies on intraoperative kinematics had the same two limitations : few assessed the reliability of the method used to evaluate intraoperative knee kinematics, and intraoperative knee kinematics was evaluated under passive and unloaded conditions. In terms of the first of these limitations, a previous study (18) confirmed the reproducibility of intraoperative kinematic analysis in TKA using a navigation system with passive unloaded knee flexion. In terms of the second limitation, some previous studies reported differences in tibio-femoral rotational kinematics between loaded and unloaded conditions.…”

Section: Discussionmentioning

confidence: 91%

“…The navigation system automatically recorded the rotation angle of the tibia (positive for internal rotation) at 10" increments from 10"to 120" of flexion. The reproducibility of this method is described elsewhere (18).…”

Section: Evaluation Of Intraoperative Kinematicsmentioning

confidence: 99%

Can intraoperative kinematic analysis predict postoperative kinematics following total knee arthroplasty? A preliminary

et al. 2017

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The preliminary study analyzed the relationship between intraoperative navigation-based kinematics and postoperative 2-dimensional/3-dimensional (2D/3D) image registration-based kinematics in total knee arthroplasty (TKA). Six knees in 5 patients were analyzed. All TKA procedures were performed using an image-free knee navigation system. Tibial internal rotation was assessed by intraoperative knee kinematics. At 1 year after surgery, tibial internal rotation was evaluated using a 2D/3D image registration technique under loaded and unloaded conditions. The correlation between intraoperative and postoperative data for the tibial internal rotation angle at 10 increments of knee flexion was then assessed. Difference in the knee flexion angle between the intraoperative and postoperative evaluations was adjusted to account for the sagittal cutting angle of the distal femur and proximal tibia. A correlation was found between the intraoperative and postoperative data for loaded knee flexion with this adjustment (Pearson's r = 0.725, p = 0.012). However, intraoperative kinematics was not significantly correlated with postoperative kinematics in the absence of loading. Larger adequately powered prospective studies are now needed to confirm our preliminary finding that postoperative loaded kinematics can be predicted by intraoperative evaluation. J. Med. Invest. 65:21-26, February, 2018.

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Measurement of rotational and coronal alignment in total knee arthroplasty using a navigation system is reproducible

Abstract: Manual intraoperative kinematic analysis using a navigation system in TKA showed excellent reproducibility. This result may encourage further studies about intraoperative kinematic analysis using a navigation system in TKA.

Cited by 17 publications

References 25 publications

Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study

Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study

Rotational and varus–valgus laxity affects kinematics of the normal knee: A cadaveric study

Can intraoperative kinematic analysis predict postoperative kinematics following total knee arthroplasty? A preliminary

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