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International Orthopaedics

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01-01-2017 | Original Paper

Postural stability after patient-specific interpositional knee spacer or total knee arthroplasty: a comparative study

Authors: Juergen Goetz, Susanne Schiessl, Clemens Baier, Silvia Dullien, Karolina Mueller, Joachim Grifka, Franz Koeck

Published in: International Orthopaedics | Issue 1/2017

Abstract

Purpose

Total knee arthroplasty provides excellent results concerning functional demands, patient satisfaction and range of motion. Short-term results after implantation of patient-specific knee spacers also show encouraging results. We hypothesised that patient-specific interpositional devices provide better proprioception and postural stability by preserving the whole bone stock and both cruciate ligaments.

Methods

In this study we compared functional results, proprioception and postural stability 16 months after 20 consecutive patient-specific interpositional device implantations of the knee (group A) and 20 consecutive total knee arthroplasties (group B). Patients were evaluated using the Knee Society Score (KSS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Postural stability was analysed during single leg stance on a force platform (Biodex).

Results

There were no significant differences between both groups concerning functional results 16 months after the procedure. Concerning postural stability, significant differences were found between both groups. Comparing the operated-on and non-operated-on sides in single leg stance, the operated-on leg gained the same stability as the non-operated-on side in both groups.

Conclusions

The successful treatment of knee osteoarthritis can restore postural stability to the level of the unaffected side—independent from the implanted devices and with preservation of soft tissue and bone stock. Superior postural stability in joint-preserving patient-specific interpositional knee devices compared with total knee arthroplasty had to be attributed to the different age of both groups.

Macintosh DL (1958) Hemiarthroplasty of the knee using a space occupying prothesis for painful varus and valgus deformities. J Bone Joint Surg Am 40-A:1431

McKeever DC (1960) Tibial plateau prosthesis. Clin Orthop Relat Res 440:4-8CrossRef

Springer BD, Scott RD, Sah AP, Carrington R (2006) McKeever hemiarthroplasty of the knee in patients less than sixty years old. J Bone Joint Surg Am 88(2):366–371PubMed

Koeck FX, Luring C, Handel M, Tingart M, Grifka J, Beckmann J (2011) Prospective single-arm, multi-center trial of a patient-specific interpositional knee implant: early clinical results. Open Orthop J 5:37–43. doi:10.2174/1874325001105010037 CrossRefPubMedPubMedCentral

Baier C, Fitz W, Craiovan B, Keshmiri A, Winkler S, Springorum R, Grifka J, Beckmann J (2014) Improved kinematics of total knee replacement following partially navigated modified gap-balancing technique. Int Orthop 38(2):243–249. doi:10.1007/s00264-013-2140-x CrossRefPubMed

Baier C, Springorum HR, Götz J, Schaumburger J, Lüring C, Grifka J, Beckmann J (2013) Comparing navigation-based in vivo knee kinematics pre- and postoperatively between a cruciate-retaining and a cruciate-substituting implant. Int Orthop 37(3):407–414. doi:10.1007/s00264-013-1798-4 CrossRefPubMedPubMedCentral

Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB, (2003) Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res (416):37–57.

Fuchs S, Tibesku CO, Frisse D, Genkinger M, Laass H, Rosenbaum D (2005) Clinical and functional comparison of uni- and bicondylar sledge prostheses. Knee Surg Sports Traumatol Arthrosc 13(3):197–202CrossRefPubMed

Woollacott MH, Tang PF (1997) Balance control during walking in the older adult: research and its implications. Phys Ther 77:646–660PubMed

10.

Arnold BL, Schmitz RJ (1998) Examination of balance measures produced by the Biodex Stability System. J Athl Train 33(4):323–327PubMedPubMedCentral

11.

Bascuas I, Tejero M, Monleón S, Boza R, Muniesa JM, Belmonte R (2013) Balance 1 year after TKA: correlation with clinical variables. Orthopedics 36(1):e6–e12. doi:10.3928/01477447-20121217-11 CrossRefPubMed

12.

Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC, Phillips E, Lipsitz LA, Collins JJ (2003) Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait Posture 18(2):101–108CrossRefPubMed

13.

Götz J, Beckmann J, Sperrer I, Baier C, Dullien S, Grifka J, Koeck F (2016) Retrospective comparative study shows no significant difference in postural stability between cruciate-retaining (CR) and cruciate-substituting (PS) total knee implant systems. Int Orthop 40(7):1441–1446. doi:10.1007/s00264-015-3067-1 CrossRefPubMed

14.

Koeck FX, Perlick L, Luring C, Handel M, Beckmann J, Linhardt O, Grifka J (2009) Leg axis correction with ConforMIS iForma (interpositional device) in unicompartmental arthritis of the knee. Int Orthop 33(4):955–960CrossRefPubMed

15.

Furnes O, Espehaug B, Lie SA, Vollset SE, Engesaeter LB, Havelin LI (2007) Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with cement. J Bone Joint Surg Am 89(3):519–525PubMed

16.

Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470(1):84–90CrossRefPubMed

17.

Steiner ME, Simon SR, Pisciotta JC, (1989) Early changes in gait and maximum knee torque following knee arthroplasty. Clin Orthop Relat Res (238):174–182

18.

Attfield SF, Wilton TJ, Pratt DJ, Sambatakakis A (1996) Soft-tissue balance and recovery of proprioception after total knee replacement. J Bone Joint Surg (Br) 78(4):540–545

19.

Pethes A, Kiss RM, Szendrői M (2014) Variability of gait in the early postoperative period of total knee arthroplasty with different surgical technique. Int Orthop 38(3):517–523. doi:10.1007/s00264-013-2115-y CrossRefPubMed

20.

Collier MB, McAuley JP, Szuszczewicz ES, Engh GA, (2004) Proprioceptive deficits are comparable before unicondylar and total knee arthroplasties, but greater in the more symptomatic knee of the patient. Clin Orthop Relat Res (423):138–143

21.

Wada M, Kawahara H, Shimada S, Miyazaki T, Baba H (2002) Joint proprioception before and after total knee arthroplasty. Clin Orthop Relat Res 403:161–167CrossRef

22.

Barrett DS, Cobb AG, Bentley G (1991) Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg (Br) 73(1):53–56

23.

Knoop J, Steultjens MP, van der Leeden M, van der Esch M, Thorstensson CA, Roorda LD, Lems WF, Dekker J (2011) Proprioception in knee osteoarthritis: a narrative review. Osteoarthr Cartil 19(4):381–388CrossRefPubMed

24.

Vandekerckhove PJ, Parys R, Tampere T, Linden P, Van den Daelen L, Verdonk PC (2015) Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome? Knee Surg Sports Traumatol Arthrosc 23(6):1644–1652CrossRefPubMed

Title: Postural stability after patient-specific interpositional knee spacer or total knee arthroplasty: a comparative study
Authors: Juergen Goetz
Susanne Schiessl
Clemens Baier
Silvia Dullien
Karolina Mueller
Joachim Grifka
Franz Koeck
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 1/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3266-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postural stability after patient-specific interpositional knee spacer or total knee arthroplasty: a comparative study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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