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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2015

01-06-2015 | Knee

Factors affecting intraoperative kinematic patterns and flexion angles in navigated total knee arthroplasty

Authors: Kazunari Ishida, Nao Shibanuma, Tomoyuki Matsumoto, Hiroshi Sasaki, Koji Takayama, Akihiko Toda, Ryosuke Kuroda, Masahiro Kurosaka

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2015

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Abstract

Purpose

To investigate the factors affecting intraoperative kinematics, as measured with a navigation system, and their effect on maximum flexion angles during total knee arthroplasty (TKA).

Method

One hundred posterior stabilised (PS) TKAs performed using an image-free navigation system were evaluated. Tibial internal rotation angles at maximum extension, 30°, 45°, 60°, 90°, and maximum flexion were collected at registration and after implantation. The varus angles from the coronal mechanical axis were also collected. The rotational patterns were divided into four groups to investigate whether flexion contracture and varus deformity affected the kinematic patterns, and correlated with the maximum pre- and post-operative flexion angles.

Results

At registration, the flexion angles at maximum extension differed significantly between the kinematic groups; the flexion angle at maximum extension at registration was negatively correlated with the pre-operative maximum flexion angle (R 2 = 0.226, p < 0.0001) and the post-operative maximum flexion angle (R 2 = 0.059, p = 0.0167). Varus deformity at registration also differed significantly between the kinematic groups; varus deformity at registration was negatively correlated with the pre-operative maximum flexion angle (R 2 = 0.087, p = 0.0036) and post-operative maximum flexion angle (R 2 = 0.101, p = 0.0027).

Conclusion

Navigation-based measurements in patients undergoing PS TKA indicated that pre-operative flexion contracture and varus deformity are negatively correlated with both pre- and post-operative maximum flexion angles. The results may improve the ease with which surgeons can interpret intraoperative kinematics, by providing a multi-dimensional perspective. With further knowledge regarding intraoperative kinematics, it might be possible to improve surgical approach, prosthesis design, and clinical outcomes.

Level of evidence

II.
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Metadata
Title
Factors affecting intraoperative kinematic patterns and flexion angles in navigated total knee arthroplasty
Authors
Kazunari Ishida
Nao Shibanuma
Tomoyuki Matsumoto
Hiroshi Sasaki
Koji Takayama
Akihiko Toda
Ryosuke Kuroda
Masahiro Kurosaka
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3572-1

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