Consistent femoral external rotation during weight-bearing knee flexion is associated with better patient-reported pain and mediolateral balance after total knee arthroplasty.
Femoral external rotation
Joint laxity
Knee kinematics
Medial pivot
Patient-reported outcomes
Total knee arthroplasty
Journal
Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
28
12
2020
revised:
11
07
2021
accepted:
19
07
2021
pubmed:
9
8
2021
medline:
27
1
2022
entrez:
8
8
2021
Statut:
ppublish
Résumé
Normal knees generally show consistent femoral external rotation during knee flexion, although knees that have had total knee arthroplasty exhibit various rotational patterns with less rotational angle. This study aimed to determine whether consistent femoral external rotation during weight-bearing knee flexion after total knee arthroplasty is associated with better patient-reported outcomes and mediolateral joint balance. A total of 40 total knee arthroplasty knees with a high-flexion posterior-stabilized prosthesis were divided into two groups based on their axial rotational kinematic pattern during squatting activity, and the clinical results including patient-reported outcomes and joint laxity were compared between the consistent external rotation group (20 knees) and the inconsistent external rotation group (20 knees). The unpaired Student's t-test or Welch's test were used for group comparison, and Fisher's exact test was applied for categorical data. "Pain at rest" and "Pain at first gait in the morning" measured using a numerical rating scale (/10) were significantly lower in the consistent external rotation group compared with those in the inconsistent external rotation group. "Pain during gait on flat surface" tended to be lower in the consistent external rotation group. Medial stability was obtained in both groups with significantly greater lateral laxity in extension in the inconsistent external rotation group. Total knee arthroplasty knees with consistent femoral external rotation during weight-bearing knee flexion exhibited better patient-reported pain and mediolateral soft tissue balance. Surgical procedures that control the mediolateral balance with medial stability would induce consistent femoral external rotation and improve patient-reported pain.
Sections du résumé
BACKGROUND
Normal knees generally show consistent femoral external rotation during knee flexion, although knees that have had total knee arthroplasty exhibit various rotational patterns with less rotational angle. This study aimed to determine whether consistent femoral external rotation during weight-bearing knee flexion after total knee arthroplasty is associated with better patient-reported outcomes and mediolateral joint balance.
METHODS
A total of 40 total knee arthroplasty knees with a high-flexion posterior-stabilized prosthesis were divided into two groups based on their axial rotational kinematic pattern during squatting activity, and the clinical results including patient-reported outcomes and joint laxity were compared between the consistent external rotation group (20 knees) and the inconsistent external rotation group (20 knees). The unpaired Student's t-test or Welch's test were used for group comparison, and Fisher's exact test was applied for categorical data.
FINDINGS
"Pain at rest" and "Pain at first gait in the morning" measured using a numerical rating scale (/10) were significantly lower in the consistent external rotation group compared with those in the inconsistent external rotation group. "Pain during gait on flat surface" tended to be lower in the consistent external rotation group. Medial stability was obtained in both groups with significantly greater lateral laxity in extension in the inconsistent external rotation group.
INTERPRETATION
Total knee arthroplasty knees with consistent femoral external rotation during weight-bearing knee flexion exhibited better patient-reported pain and mediolateral soft tissue balance. Surgical procedures that control the mediolateral balance with medial stability would induce consistent femoral external rotation and improve patient-reported pain.
Identifiants
pubmed: 34365053
pii: S0268-0033(21)00168-6
doi: 10.1016/j.clinbiomech.2021.105438
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105438Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.