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Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion

PURPOSE: This study aimed to evaluate kinematically aligned total knee arthroplasty (KA-TKA) targeting the neutral ground mechanical axis (MA) (hip-to-calcaneus axis), the line from the hip centre to the bottom of the calcaneus, (ground KA-TKA) in terms of its comparison with tibia-restricted modifi...

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Autores principales: Matsumoto, Tomoyuki, Nakano, Naoki, Ishida, Kazunari, Kuroda, Yuichi, Hayashi, Shinya, Muratsu, Hirotsugu, Kuroda, Ryosuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439075/
https://www.ncbi.nlm.nih.gov/pubmed/37086287
http://dx.doi.org/10.1007/s00264-023-05799-6
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author Matsumoto, Tomoyuki
Nakano, Naoki
Ishida, Kazunari
Kuroda, Yuichi
Hayashi, Shinya
Muratsu, Hirotsugu
Kuroda, Ryosuke
author_facet Matsumoto, Tomoyuki
Nakano, Naoki
Ishida, Kazunari
Kuroda, Yuichi
Hayashi, Shinya
Muratsu, Hirotsugu
Kuroda, Ryosuke
author_sort Matsumoto, Tomoyuki
collection PubMed
description PURPOSE: This study aimed to evaluate kinematically aligned total knee arthroplasty (KA-TKA) targeting the neutral ground mechanical axis (MA) (hip-to-calcaneus axis), the line from the hip centre to the bottom of the calcaneus, (ground KA-TKA) in terms of its comparison with tibia-restricted modified KA-TKA (modified KA-TKA). METHODS: This retrospective cohort study included 106 consecutive patients who underwent unilateral KA-TKA for varus osteoarthritis (OA) (60 modified KA-TKAs and 46 ground KA-TKAs). After 1:1 propensity score matching, 60 patients (30 pairs) were matched between the groups with comparable demographic data. The hip-knee-ankle (HKA) angle, coronal femoral component alignment (FCA), and coronal tibial component alignment (TCA) were compared between groups. Intraoperative soft tissue balance, including the joint component gap and varus/valgus balance, was also compared between the groups. One year postoperatively, the clinical outcomes, including the range of motion and 2011 Knee Society Score, were compared between groups. RESULTS: The HKA angle and FCA/TCA were not significantly different between groups. Whereas the varus/valgus balance showed no significant differences between groups, smaller joint component gaps were found throughout the range of motion in the ground KA-TKA group than in the modified KA-TKA group. Despite no difference in clinical scores between groups, a significantly deeper postoperative flexion angle was achieved in the ground KA-TKA group than in the modified KA-TKA group (p < 0.05). CONCLUSION: Targeting neutral ground MA in KA-TKA for patients with varus OA has the potential to provide a better flexion angle with stable intraoperative soft tissue balance.
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spelling pubmed-104390752023-08-20 Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion Matsumoto, Tomoyuki Nakano, Naoki Ishida, Kazunari Kuroda, Yuichi Hayashi, Shinya Muratsu, Hirotsugu Kuroda, Ryosuke Int Orthop Original Paper PURPOSE: This study aimed to evaluate kinematically aligned total knee arthroplasty (KA-TKA) targeting the neutral ground mechanical axis (MA) (hip-to-calcaneus axis), the line from the hip centre to the bottom of the calcaneus, (ground KA-TKA) in terms of its comparison with tibia-restricted modified KA-TKA (modified KA-TKA). METHODS: This retrospective cohort study included 106 consecutive patients who underwent unilateral KA-TKA for varus osteoarthritis (OA) (60 modified KA-TKAs and 46 ground KA-TKAs). After 1:1 propensity score matching, 60 patients (30 pairs) were matched between the groups with comparable demographic data. The hip-knee-ankle (HKA) angle, coronal femoral component alignment (FCA), and coronal tibial component alignment (TCA) were compared between groups. Intraoperative soft tissue balance, including the joint component gap and varus/valgus balance, was also compared between the groups. One year postoperatively, the clinical outcomes, including the range of motion and 2011 Knee Society Score, were compared between groups. RESULTS: The HKA angle and FCA/TCA were not significantly different between groups. Whereas the varus/valgus balance showed no significant differences between groups, smaller joint component gaps were found throughout the range of motion in the ground KA-TKA group than in the modified KA-TKA group. Despite no difference in clinical scores between groups, a significantly deeper postoperative flexion angle was achieved in the ground KA-TKA group than in the modified KA-TKA group (p < 0.05). CONCLUSION: Targeting neutral ground MA in KA-TKA for patients with varus OA has the potential to provide a better flexion angle with stable intraoperative soft tissue balance. Springer Berlin Heidelberg 2023-04-22 2023-09 /pmc/articles/PMC10439075/ /pubmed/37086287 http://dx.doi.org/10.1007/s00264-023-05799-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Matsumoto, Tomoyuki
Nakano, Naoki
Ishida, Kazunari
Kuroda, Yuichi
Hayashi, Shinya
Muratsu, Hirotsugu
Kuroda, Ryosuke
Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title_full Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title_fullStr Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title_full_unstemmed Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title_short Ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
title_sort ground kinematically aligned total knee arthroplasty: new personalized technique which enables a stable knee with deep flexion
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439075/
https://www.ncbi.nlm.nih.gov/pubmed/37086287
http://dx.doi.org/10.1007/s00264-023-05799-6
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