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The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system

BACKGROUND AND PURPOSE: Postoperative anterior knee pain is one of the most frequent complications after total knee arthroplasty (TKA). Changes in patellar kinematics after TKA relative to the preoperative arthritic knee are not well understood. We compared the patellar kinematics preoperatively wit...

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Autores principales: Keshmiri, Armin, Maderbacher, Günther, Baier, Clemens, Sendtner, Ernst, Schaumburger, Jens, Zeman, Florian, Grifka, Joachim, Springorum, Hans R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513599/
https://www.ncbi.nlm.nih.gov/pubmed/25582349
http://dx.doi.org/10.3109/17453674.2015.1005907
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author Keshmiri, Armin
Maderbacher, Günther
Baier, Clemens
Sendtner, Ernst
Schaumburger, Jens
Zeman, Florian
Grifka, Joachim
Springorum, Hans R
author_facet Keshmiri, Armin
Maderbacher, Günther
Baier, Clemens
Sendtner, Ernst
Schaumburger, Jens
Zeman, Florian
Grifka, Joachim
Springorum, Hans R
author_sort Keshmiri, Armin
collection PubMed
description BACKGROUND AND PURPOSE: Postoperative anterior knee pain is one of the most frequent complications after total knee arthroplasty (TKA). Changes in patellar kinematics after TKA relative to the preoperative arthritic knee are not well understood. We compared the patellar kinematics preoperatively with the kinematics after ligament-balanced navigated TKA. PATIENTS AND METHODS: We measured patellar tracking before and after ligament-balanced TKA in 40 consecutive patients using computer navigation. Furthermore, the influences of different femoral and tibial component alignment on patellar kinematics were analyzed using generalized linear models. RESULTS: After TKA, the patellae shifted statistically significantly more laterally between 30° and 60°. The lateral tilt increased at 90° of flexion whereas the epicondylar distance decreased between 45° and 75° of flexion. Sagittal component alignment, but not rotational component alignment, had a significant influence on patellar kinematics. INTERPRETATION: There are major differences in patellar kinematics between the preoperative arthritic knee and the knee after TKA. Combined sagittal component alignment in particular appears to have a major effect on patellar kinematics. Surgeons should be especially aware of altering preoperative sagittal alignment until the possible clinical relevance has been investigated.
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spelling pubmed-45135992015-08-10 The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system Keshmiri, Armin Maderbacher, Günther Baier, Clemens Sendtner, Ernst Schaumburger, Jens Zeman, Florian Grifka, Joachim Springorum, Hans R Acta Orthop Knee BACKGROUND AND PURPOSE: Postoperative anterior knee pain is one of the most frequent complications after total knee arthroplasty (TKA). Changes in patellar kinematics after TKA relative to the preoperative arthritic knee are not well understood. We compared the patellar kinematics preoperatively with the kinematics after ligament-balanced navigated TKA. PATIENTS AND METHODS: We measured patellar tracking before and after ligament-balanced TKA in 40 consecutive patients using computer navigation. Furthermore, the influences of different femoral and tibial component alignment on patellar kinematics were analyzed using generalized linear models. RESULTS: After TKA, the patellae shifted statistically significantly more laterally between 30° and 60°. The lateral tilt increased at 90° of flexion whereas the epicondylar distance decreased between 45° and 75° of flexion. Sagittal component alignment, but not rotational component alignment, had a significant influence on patellar kinematics. INTERPRETATION: There are major differences in patellar kinematics between the preoperative arthritic knee and the knee after TKA. Combined sagittal component alignment in particular appears to have a major effect on patellar kinematics. Surgeons should be especially aware of altering preoperative sagittal alignment until the possible clinical relevance has been investigated. Informa Healthcare 2015-08 2015-07-21 /pmc/articles/PMC4513599/ /pubmed/25582349 http://dx.doi.org/10.3109/17453674.2015.1005907 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.
spellingShingle Knee
Keshmiri, Armin
Maderbacher, Günther
Baier, Clemens
Sendtner, Ernst
Schaumburger, Jens
Zeman, Florian
Grifka, Joachim
Springorum, Hans R
The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title_full The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title_fullStr The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title_full_unstemmed The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title_short The influence of component alignment on patellar kinematics in total knee arthroplasty: An in vivo study using a navigation system
title_sort influence of component alignment on patellar kinematics in total knee arthroplasty: an in vivo study using a navigation system
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513599/
https://www.ncbi.nlm.nih.gov/pubmed/25582349
http://dx.doi.org/10.3109/17453674.2015.1005907
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