Varus kinematics at knee flexion affect clinical outcomes of unicompartmental knee arthroplasty: Intraoperative navigation-based kinematics evaluation.
Alignment
Kinematics
Navigation
Unicompartmental knee arthroplasty
Varus
Journal
Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology
ISSN: 2214-6873
Titre abrégé: Asia Pac J Sports Med Arthrosc Rehabil Technol
Pays: Singapore
ID NLM: 101648546
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
10
09
2019
revised:
11
01
2020
accepted:
16
01
2020
entrez:
12
2
2020
pubmed:
12
2
2020
medline:
12
2
2020
Statut:
epublish
Résumé
The aim of the study was to investigate the effects of navigation-based varus or axial rotational alignment through knee flexion on patient reported outcomes or the maximum flexion angle of unicompartmental knee arthroplasty (UKA). Data were retrospectively collected from 46 knees that underwent UKA for medial unicompartmental knee osteoarthritis. An image-free knee navigation system was used in all cases, and intraoperative varus and axial rotational alignment at every knee flexion angle were recorded before and after implantation. All patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS) at final follow-up. By varus or valgus at 0° knee flexion, the knees were subdivided into two groups (varus at 0° group, varus above the median value; neutral at 0° group, varus equal to or below the median value). By varus or valgus at 90° knee flexion, patients were similarly subdivided into two groups (varus at 90° group; neutral at 90° group). The maximum knee flexion angle was measured 3 months after surgery. There were no differences in the KOOS between the neutral at 0° group and the varus at 0° group. However, the KOOS activity score (79 ± 17 vs 69 ± 16, p = 0.02) and the KOOS total score (72 ± 17 vs 65 ± 15, p = 0.03) of the neutral at 90° group were better than those of the varus at 90° group. The alignment and the maximum knee flexion angle 3 months after surgery were not correlated. Varus at 0° knee flexion and axial rotational alignment did not affect the clinical outcomes of UKA. Patient reported outcomes was better for the neutral knees with less varus at 90° knee flexion than for varus knees.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of the study was to investigate the effects of navigation-based varus or axial rotational alignment through knee flexion on patient reported outcomes or the maximum flexion angle of unicompartmental knee arthroplasty (UKA).
METHODS
METHODS
Data were retrospectively collected from 46 knees that underwent UKA for medial unicompartmental knee osteoarthritis. An image-free knee navigation system was used in all cases, and intraoperative varus and axial rotational alignment at every knee flexion angle were recorded before and after implantation. All patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS) at final follow-up. By varus or valgus at 0° knee flexion, the knees were subdivided into two groups (varus at 0° group, varus above the median value; neutral at 0° group, varus equal to or below the median value). By varus or valgus at 90° knee flexion, patients were similarly subdivided into two groups (varus at 90° group; neutral at 90° group). The maximum knee flexion angle was measured 3 months after surgery.
RESULTS
RESULTS
There were no differences in the KOOS between the neutral at 0° group and the varus at 0° group. However, the KOOS activity score (79 ± 17 vs 69 ± 16, p = 0.02) and the KOOS total score (72 ± 17 vs 65 ± 15, p = 0.03) of the neutral at 90° group were better than those of the varus at 90° group. The alignment and the maximum knee flexion angle 3 months after surgery were not correlated.
CONCLUSION
CONCLUSIONS
Varus at 0° knee flexion and axial rotational alignment did not affect the clinical outcomes of UKA. Patient reported outcomes was better for the neutral knees with less varus at 90° knee flexion than for varus knees.
Identifiants
pubmed: 32042597
doi: 10.1016/j.asmart.2020.01.002
pii: S2214-6873(19)30058-5
pmc: PMC6997613
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6-11Informations de copyright
© 2020 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.
Déclaration de conflit d'intérêts
All authors have no conflict of interest. This study was approved by the institutional review board of the Hakodate Goryoukaku Hospital (Reference number: 2016-072).
Références
Knee Surg Relat Res. 2012 Jun;24(2):85-90
pubmed: 22708108
J Arthroplasty. 2016 May;31(5):1096-101
pubmed: 26730450
J Arthroplasty. 2014 Apr;29(4):702-6
pubmed: 23958237
J Orthop Res. 2006 Apr;24(4):588-94
pubmed: 16514655
J Bone Joint Surg Br. 2009 Apr;91(4):469-74
pubmed: 19336806
J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96
pubmed: 9699158
Clin Orthop Relat Res. 1999 Oct;(367):50-60
pubmed: 10546598
Knee Surg Sports Traumatol Arthrosc. 2016 Aug;24(8):2447-52
pubmed: 26846657
Knee Surg Sports Traumatol Arthrosc. 2015 Jun;23(6):1741-7
pubmed: 25763851
Acta Orthop Belg. 2009 Feb;75(1):45-50
pubmed: 19358398
Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):89-95
pubmed: 25261225
Clin Orthop Relat Res. 1987 Aug;(221):278-85
pubmed: 3608312
J Orthop Res. 2009 Feb;27(2):202-7
pubmed: 18752279
J Arthroplasty. 2017 May;32(5):1443-1452
pubmed: 28039023
Clin Orthop Relat Res. 2005 Jul;(436):172-6
pubmed: 15995437
J Bone Joint Surg Am. 2005 Feb;87(2):332-8
pubmed: 15687156
Clin Biomech (Bristol, Avon). 2016 Jan;31:33-9
pubmed: 26518281
Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2211-2217
pubmed: 30030580
Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1911-7
pubmed: 24213684
Int Orthop. 2013 May;37(5):803-8
pubmed: 23460410
J Arthroplasty. 2016 Jul;31(7):1453-8
pubmed: 26928182