Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2016

01-08-2016 | Knee

Navigation-based tibial rotation at 90° of flexion is associated with better range of motion in navigated total knee arthroplasty

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

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2016

Login to get access

Abstract

Purpose

In clinical practice, people with better femorotibial rotation in the flexed position often achieve a favourable postoperative maximum flexion angle (MFA). However, no objective data have been reported to support this clinical observation. In the present study, we aimed to investigate the correlation between the amount of intraoperative rotation and the pre- and postoperative flexion angles.

Methods

Fifty-five patients with varus osteoarthritis undergoing computer-assisted posterior-stabilized total knee arthroplasty (TKA) were enrolled. After registration, rotational stress was applied towards the knee joint, and the rotational angles were recorded by using a navigation system at maximum extension and 90° of flexion. After implantation, rotational stress was applied for a second time, and the angles were recorded once more. The MFA was measured before surgery and 1 month after surgery, and the correlation between the amount of femorotibial rotation during surgery and the MFA was statistically evaluated.

Results

Although the amount of tibial rotation at maximum extension was not correlated with the MFA, the amount of tibial rotation at 90° of flexion after registration was positively correlated with the pre- and postoperative MFA (both p < 0.005). However, no significant relationship was observed between the amount of tibial rotation after implantation and the postoperative MFA (n.s.).

Conclusion

The results showed that better femorotibial rotation at 90° of flexion is associated with a favourable postoperative MFA, suggesting that the flexibility of the surrounding soft tissues is an important factor for obtaining a better MFA, which has important clinical relevance. Hence, further evaluation of navigation-based kinematics during TKA may provide useful information on MFA.

Level of evidence

Diagnostic studies, development of diagnostic criteria in a consecutive series of patients, and a universally applied “gold” standard, Level II.
Literature
1.
Akagi M, Mori S, Nishimura S, Nishimura A, Asano T, Hamanishi C (2005) Variability of extraarticular tibial rotation references for total knee arthroplasty. Clin Orthop Relat Res 436:172–176CrossRefPubMed
2.
Belvedere C, Ensini A, Leardini A, Dedda V, Feliciangeli A, Cenni F, Timoncini A, Barbadoro P, Giannini S (2014) Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 22(8):1719–1727CrossRefPubMed
3.
Bignozzi S, Zaffagnini S, Akkawi I, Marko T, Bruni D, Neri MP, Colle F, Marcacci M (2014) Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical differences. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3200-5
4.
Chinzei N, Ishida K, Matsumoto T, Kuroda Y, Kitagawa A, Kuroda R, Akisue T, Nishida K, Kurosaka M, Tsumura N (2014) Evaluation of patellofemoral joint in ADVANCE Medial-pivot total knee arthroplasty. Int Orthop 38(3):509–515CrossRefPubMed
5.
Fujimoto E, Sasashige Y, Masuda Y, Hisatome T, Eguchi A, Masuda T, Sawa M, Nagata Y (2013) Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 21(12):2704–2712CrossRefPubMed
6.
Ghosh KM, Blain AP, Longstaff L, Rushton S, Amis AA, Deehan DJ (2014) Can we define envelope of laxity during navigated knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 22(8):1736–1743CrossRefPubMed
7.
Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, Iguchi T, Kurosaka M, Kuroda R (2011) Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(7):1107–1112CrossRefPubMed
8.
Ishida K, Shibanuma N, Matsumoto T, Sasaki H, Takayama K, Matsuzaki T, Tei K, Kuroda R, Kurosaka M (2016) Navigation-based femorotibial rotation pattern correlated with flexion angle after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 24(1):89–95CrossRefPubMed
9.
Ishida K, Shibanuma N, Matsumoto T, Sasaki H, Takayama K, Toda A, Kuroda R, Kurosaka M (2015) Factors affecting intraoperative kinematic patterns and flexion angles in navigated total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23(6):1741–1747CrossRefPubMed
10.
Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplast 20(7):832–839CrossRef
11.
Kitagawa A, Ishida K, Chin T, Tsumura N, Iguchi T (2014) Partial restoration of knee kinematics in severe valgus deformity using the medial-pivot total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(7):1599–1606CrossRefPubMed
12.
Langlois J, Charles-Nelson A, Katsahian S, Beldame J, Lefebvre B, Bercovy M (2015) Predictors of flexion using the rotating concave–convex total knee arthroplasty: preoperative range of motion is not the only determinant. Knee Surg Sports Traumatol Arthrosc 23(6):1734–1740CrossRefPubMed
13.
Martin A, Wohlgenannt O, Prenn M, Oelsch C, von Strempel A (2007) Imageless navigation for TKA increases implantation accuracy. Clin Orthop Relat Res 460:178–184PubMed
14.
Matsuzaki T, Matsumoto T, Kubo S, Muratsu H, Matsushita T, Kawakami Y, Ishida K, Oka S, Kuroda R, Kurosaka M (2014) Tibial internal rotation is affected by lateral laxity in cruciate-retaining total knee arthroplasty: an intraoperative kinematic study using a navigation system and offset-type tensor. Knee Surg Sports Traumatol Arthrosc 22(3):615–620CrossRefPubMed
15.
Matsuzaki T, Matsumoto T, Muratsu H, Kubo S, Matsushita T, Kawakami Y, Ishida K, Oka S, Kuroda R, Kurosaka M (2013) Kinematic factors affecting postoperative knee flexion after cruciate-retaining total knee arthroplasty. Int Orthop 37(5):803–808CrossRefPubMedPubMedCentral
16.
Nishio Y, Onodera T, Kasahara Y, Takahashi D, Iwasaki N, Majima T (2014) Intraoperative medial pivot affects deep knee flexion angle and patient-reported outcomes after total knee arthroplasty. J Arthroplast 29(4):702–706CrossRef
17.
Roh YW, Jang J, Choi WC, Lee JK, Chun SH, Lee S, Seong SC, Lee MC (2013) Preservation of the posterior cruciate ligament is not helpful in highly conforming mobile-bearing total knee arthroplasty: a randomized controlled study. Knee Surg Sports Traumatol Arthrosc 21(12):2850–2859CrossRefPubMed
18.
Rosskopf J, Singh PK, Wolf P, Strauch M, Graichen H (2014) Influence of intentional femoral component flexion in navigated TKA on gap balance and sagittal anatomy. Knee Surg Sports Traumatol Arthrosc 22(3):687–693CrossRefPubMed
19.
Seon JK, Park JK, Shin YJ, Seo HY, Lee KB, Song EK (2011) Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs. Knee Surg Sports Traumatol Arthrosc 19(12):2016–2022CrossRefPubMed
20.
Siston RA, Giori NJ, Goodman SB, Delp SL (2006) Intraoperative passive kinematics of osteoarthritic knees before and after total knee arthroplasty. J Orthop Res 24(8):1607–1614CrossRefPubMed
21.
Stiehl JB, Dennis DA, Komistek RD, Crane HS (1999) In vivo determination of condylar lift-off and screw-home in a mobile-bearing total knee arthroplasty. J Arthroplast 14(3):293–299CrossRef
22.
Tei K, Ishida K, Matsumoto T, Kubo S, Sasaki H, Shibanuma N, Akisue T, Nishida K, Kurosaka M, Kuroda R (2012) Novel image-matching software for postoperative evaluation after TKA. Orthopedics 35(12):e1711–e1715CrossRefPubMed
23.
Turcot K, Armand S, Lubbeke A, Fritschy D, Hoffmeyer P, Suva D (2013) Does knee alignment influence gait in patients with severe knee osteoarthritis? Clin Biomech 28(1):34–39CrossRef
24.
Wunschel M, Leasure JM, Dalheimer P, Kraft N, Wulker N, Muller O (2013) Differences in knee joint kinematics and forces after posterior cruciate retaining and stabilized total knee arthroplasty. Knee 20(6):416–421CrossRefPubMed
25.
Zaffagnini S, Bignozzi S, Saffarini M, Colle F, Sharma B, Kinov PS, Marcacci M, Dejour D (2014) Comparison of stability and kinematics of the natural knee versus a PS TKA with a ‘third condyle’. Knee Surg Sports Traumatol Arthrosc 22(8):1778–1785CrossRefPubMed
Metadata
Title
Navigation-based tibial rotation at 90° of flexion is associated with better range of motion in navigated total knee arthroplasty
Authors
Kazunari Ishida
Nao Shibanuma
Tomoyuki Matsumoto
Hiroshi Sasaki
Koji Takayama
Yuji Hiroshima
Ryosuke Kuroda
Masahiro Kurosaka
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4008-2

Other articles of this Issue 8/2016

Knee Surgery, Sports Traumatology, Arthroscopy 8/2016 Go to the issue

Knee

Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting

Knee

Kinematically aligned TKA can align knee joint line to horizontal

Knee

Changes in femoral posterior condylar offset and knee flexion after PCL-substituting total knee arthroplasty: comparison of anterior and posterior referencing systems

Knee

No condylar lift-off occurs because of excessive lateral soft tissue laxity in neutrally aligned total knee arthroplasty: a computer simulation study

Knee

Shorter survival rate in varus-aligned knees after total knee arthroplasty

Knee

Change in collateral ligament length and tibiofemoral movement following joint line variation in TKA