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01-12-2022 | Osteoarthrosis | Research

Femoral rollback at high-flexion during squatting is related to the improvement of sports activities after bicruciate-stabilized total knee arthroplasty: an observational study

Authors: Kenichi Kono, Hiroshi Inui, Tomofumi Kage, Tetsuya Tomita, Takaharu Yamazaki, Shuji Taketomi, Ryota Yamagami, Kohei Kawaguchi, Sakae Tanaka

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

In bicruciate-stabilized total knee arthroplasty (BCS-TKA), the relationship between the postoperative kinematics and sports subscales in patient-reported outcome measures (PROMs) remains unknown. The purpose of this study was to determine the relationship between kinematics and sports subscales using the PROMs after BCS-TKA.

Methods

Sixty-one patients with severe knee osteoarthritis were examined at 13.5 ± 7.8 months after BCS-TKA. The patients performed squats under single fluoroscopic surveillance in the sagittal plane. Range of motion of the knee, axial rotation of the femur relative to the tibial component, and anteroposterior (AP) translation of the medial and lateral femorotibial contact points were measured using a 2D-to-3D registration technique. In addition, the relationship between the kinematics and improvement of the sports subscales in the Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated.

Results

In rotation angle, the femoral external rotation was observed from 0 to 50° of flexion. The amount of femoral external rotation did not correlate with PROMs-SP. In medial AP translation, posterior translation was observed from 0 to 20° and 80–110° of flexion. Mild anterior translation was observed from 20 to 80° of flexion. Beyond 80° of flexion, posterior translation was positively correlated with squatting. In lateral AP translation, posterior translation was observed from 0 to 20° and 80–110° of flexion. Beyond 80° of flexion, posterior translation was positively correlated with running, jumping, twisting/pivoting, and kneeling.

Conclusion

Femoral rollback at high flexion during squatting may be important to improve sports performance after BCS-TKA.

Kono K, Inui H, Tomita T, Yamazaki T, Taketomi S, Sugamoto K, et al. Bicruciate-stabilised total knee arthroplasty provides good functional stability during high-flexion weight-bearing activities. Knee Surg Sports Traumatol Arthrosc. 2019;27:2096–103. https://doi.org/10.1007/s00167-019-05375-9.CrossRefPubMed

Luyckx L, Luyckx T, Bellemans J, Victor J. Iliotibial band traction syndrome in guided motion TKA. A new clinical entity after TKA. Acta Orthop Belg. 2010;76:507–12.PubMed

Christen B, Kopjar B. Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor. Arch Orthop Trauma Surg. 2018;138:1591–9. https://doi.org/10.1007/s00402-018-3019-5.CrossRefPubMedPubMedCentral

Kaneko T, Kono N, Mochizuki Y, Hada M, Toyoda S, Musha Y. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range. J Orthop. 2017;14:201–6. https://doi.org/10.1016/j.jor.2016.12.005.CrossRefPubMedPubMedCentral

Inui H, Taketomi S, Yamagami R, Kono K, Kawaguchi K, Takagi K, et al. Comparison of intraoperative kinematics and their influence on the clinical outcomes between posterior stabilized total knee arthroplasty and bi-cruciate stabilized total knee arthroplasty. Knee. 2020;27:1263–70. https://doi.org/10.1016/j.knee.2020.06.008.CrossRefPubMed

Healy WL, Sharma S, Schwartz B, Iorio R. Athletic activity after total joint arthroplasty. J Bone Joint Surg Am. 2008;90:2245–52. https://doi.org/10.2106/JBJS.H.00274.CrossRefPubMed

Crawford DA, Adams JB, Hobbs GR, Berend KR, Lombardi AV Jr. Higher activity level following total knee arthroplasty is not deleterious to mid-term implant survivorship. J Arthroplast. 2020;35:116–20. https://doi.org/10.1016/j.arth.2019.07.044.CrossRef

Witjes S, Gouttebarge V, Kuijer PP, van Geenen RC, Poolman RW, Kerkhoffs GM. Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and meta-analysis. Sports Med. 2016;46:269–92. https://doi.org/10.1007/s40279-015-0421-9.CrossRefPubMedPubMedCentral

Mont MA, Marker DR, Seyler TM, Jones LC, Kolisek FR, Hungerford DS. High-impact sports after total knee arthroplasty. J Arthroplast. 2008;23(Suppl 1):80–4. https://doi.org/10.1016/j.arth.2008.04.018.CrossRef

10.

Huch K, Müller KA, Stürmer T, Brenner H, Puhl W, Günther KP. Sports activities 5 years after total knee or hip arthroplasty: the Ulm osteoarthritis study. Ann Rheum Dis. 2005;64:1715–20. https://doi.org/10.1136/ard.2004.033266.CrossRefPubMedPubMedCentral

11.

Matsuda S, Kawahara S, Okazaki K, Tashiro Y, Iwamoto Y. Postoperative alignment and ROM affect patient satisfaction after TKA. Clin Orthop Relat Res. 2013;471:127–33. https://doi.org/10.1007/s11999-012-2533-y.CrossRefPubMed

12.

Matsushita Y, Hamai S, Okazaki K, Murakami K, Ma Y, Kiyohara M, et al. Recreational sports, workout and gym activities after total knee arthroplasty: Asian cohort study. J Orthop. 2019;16:41–4. https://doi.org/10.1016/j.jor.2018.12.002.CrossRefPubMed

13.

Kage T, Inui H, Tomita T, Yamazaki T, Taketomi S, Yamagami R, et al. The association between in vivo knee kinematics and patient-reported outcomes during squatting in Bicruciate-stabilized total knee arthroplasty. J Knee Surg. 2021. https://doi.org/10.1055/s-0041-1723763.

14.

Pizza N, Di Paolo S, Zinno R, Marcheggiani Muccioli GM, Agostinone P, Alesi D, et al. Over-constrained kinematic of the medial compartment leads to lower clinical outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2021. https://doi.org/10.1007/s00167-020-06398-3.

15.

Kono K, Inui H, Tomita T, Yamazaki T, Taketomi S, Yamagami R, et al. The higher patient-reported outcome measure group had smaller external rotation of the femur in bicruciate-stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2021. https://doi.org/10.1007/s00167-021-06577-w.

16.

Van Onsem S, Verstraete M, Van Eenoo W, Van Der Straeten C, Victor J. Are TKA kinematics during closed kinetic chain exercises associated with patient-reported outcomes? A preliminary analysis. Clin Orthop Relat Res. 2020;478:255–63. https://doi.org/10.1097/CORR.0000000000000991.CrossRefPubMed

17.

Yamazaki T, Watanabe T, Nakajima Y, Sugamoto K, Tomita T, Yoshikawa H, et al. Improvement of depth position in 2-D/3-D registration of knee implants using single-plane fluoroscopy. IEEE Trans Med Imaging. 2004;23:602–12 http://ieeexplore.ieee.org/ielx5/42/28807/01295080.pdf?tp=&arnumber=1295080&isnumber=28807.CrossRef

18.

Yamazaki T, Watanabe T, Nakajima Y, Sugamoto K, Tomita T, Maeda D, et al. Visualization of femorotibial contact in total knee arthroplasty using X-ray fluoroscopy. Eur J Radiol. 2005;53:84–9. https://doi.org/10.1016/j.ejrad.2003.09.018.CrossRefPubMed

19.

Shimizu N, Tomita T, Yamazaki T, Yoshikawa H, Sugamoto K. The effect of weight-bearing condition on kinematics of a high-flexion, posterior-stabilized knee prosthesis. J Arthroplast. 2011;26:1031–7. https://doi.org/10.1016/j.arth.2011.01.008.CrossRef

20.

Nakamura N, Takeuchi R, Sawaguchi T, Ishikawa H, Saito T, Goldhahn S. Cross-cultural adaptation and validation of the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS). J Orthop Sci. 2011;16:516–23. https://doi.org/10.1007/s00776-011-0112-9.CrossRefPubMed

21.

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60. https://doi.org/10.3758/BRM.41.4.1149.CrossRefPubMed

22.

Kono K, Tomita T, Futai K, Yamazaki T, Tanaka S, Yoshikawa H, et al. In vivo three-dimensional kinematics of normal knees during different high-flexion activitie. Bone Joint J. 2018;100–B:50–5. https://doi.org/10.1302/0301-620X.100B1.BJJ-2017-0553.R2.CrossRefPubMedPubMedCentral

23.

Hill PF, Vedi V, Williams A, Iwaki H, Pinskerova V, Freeman MA. Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI. J Bone Joint Surg Br. 2000;82:1196–8 http://bjj.boneandjoint.org.uk/content/jbjsbr/82-B/8/1196.full.pdf.CrossRef

24.

Kosse NM, Heesterbeek PJC, Defoort KC, Wymenga AB, van Hellemondt GG. Maximal flexion and patient outcomes after TKA, using a bicruciate-stabilizing design. Arch Orthop Trauma Surg. 2020;140:1495–501. https://doi.org/10.1007/s00402-020-03491-7.CrossRefPubMed

25.

Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 2003;416:37–57. https://doi.org/10.1097/01.blo.0000092986.12414.b5.CrossRef

26.

Hanreich C, Martelanz L, Koller U, Windhager R, Waldstein W. Sport and physical activity following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplasty. 2020;35:2274–2285.e1. https://doi.org/10.1016/j.arth.2020.04.013.CrossRefPubMed

27.

Bradbury N, Borton D, Spoo G, Cross MJ. Participation in sports after total knee replacement. Am J Sports Med. 1998;26:530–5. https://doi.org/10.1177/03635465980260041001.CrossRefPubMed

28.

Hepperger C, Gföller P, Abermann E, Hoser C, Ulmer H, Herbst E, et al. Sports activity is maintained or increased following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;26:1515–23. https://doi.org/10.1007/s00167-017-4529-3.CrossRefPubMed

29.

Ishibashi T, Tomita T, Yamazaki T, Tsuji S, Yoshikawa H, Sugamoto K. Kinematics of bicruciate and posterior stabilized total knee arthroplasty during deep knee flexion and stair climbing. J Orthop Res. 2021;39:1262–70. https://doi.org/10.1002/jor.24773.CrossRefPubMed

30.

Vielgut I, Leitner L, Kastner N, Radl R, Leithner A, Sadoghi P. Sports activity after low-contact-stress total knee arthroplasty - a long term follow-up study. Sci Rep. 2016;6:24630. https://doi.org/10.1038/srep24630.CrossRefPubMedPubMedCentral

31.

Ho JC, Stitzlein RN, Green CJ, Stoner T, Froimson MI. Return to sports activity following UKA and TKA. J Knee Surg. 2016;29:254–9. https://doi.org/10.1055/s-0035-1551835.CrossRefPubMed

32.

Kono K, Inui H, Tomita T, Yamazaki T, Taketomi S, Tanaka S. In vivo kinematics of bicruciate-retaining total knee arthroplasty with anatomical articular surface under high-flexion conditions. J Knee Surg. 2021;34:452–9. https://doi.org/10.1055/s-0039-1696959.CrossRefPubMed

Title: Femoral rollback at high-flexion during squatting is related to the improvement of sports activities after bicruciate-stabilized total knee arthroplasty: an observational study
Authors: Kenichi Kono
Hiroshi Inui
Tomofumi Kage
Tetsuya Tomita
Takaharu Yamazaki
Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Sakae Tanaka
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05464-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Femoral rollback at high-flexion during squatting is related to the improvement of sports activities after bicruciate-stabilized total knee arthroplasty: an observational study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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