Abstract

Purpose

To evaluate if there was a correlation between in vivo kinematics of a medial-stabilized (MS) total knee arthroplasty (TKA) and post-operative clinical scores. We hypothesized that (1) a MS-TKA would produce a medial pivot movement and that (2) this specific pattern would be correlated with higher clinical scores.

Methods

18 patients were evaluated through clinical and functional scores evaluation (Knee Society Score clinical and functional, Womac, Oxford), and kinematically through dynamic radiostereometric analysis (RSA) at 9 months after MS-TKA, during the execution of a sit-to-stand and a lunge motor task. The anteroposterior (AP) Low Point translation of medial and lateral femoral compartments was compared through Student’s t test (p < 0.05). A correlation analysis between scores and kinematics was performed through the Pearson’s correlation coefficient r.

Results

A significantly greater (p < 0.0001) anterior translation of the lateral compartment with respect to the medial one was found in both sit-to-stand (medial 2.9 mm ± 0.7 mm, lateral 7.1 mm ± 0.6 mm) and lunge (medial 5.3 mm ± 0.9 mm, lateral 10.9 mm ± 0.7 mm) motor tasks, thus resulting in a medial pivot pattern in about 70% of patients. Significant positive correlation in sit-to-stand was found between the peak of AP translation in the lateral compartment and clinical scores (r = 0.59 for Knee Society Score clinical and r = 0.61 for Oxford). Moreover, we found that the higher peak of AP translation of the medial compartment correlated with lower clinical scores (r = − 0.55 for Knee Society Score clinical, r = − 0.61 for Womac and r = − 0.53 for Oxford) in the lunge. A negative correlation was found between Knee Society Score clinical and VV laxity during sit-to-stand (r = − 0.56) and peak of external rotation in the lunge motor task (r = − 0.66).

Conclusions

The MS-TKA investigated produced in vivo a medial pivot movement in about 70% of patients in both examined motor tasks. There was a correlation between the presence of medial pivot and higher post-operative scores.

Level of evidence

IV.

中文翻译：

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内侧稳定全膝关节置换术的体内股骨运动学与术后临床结局相关

摘要

目的

为了评估内侧稳定（MS）全膝关节置换术（TKA）的体内运动学与术后临床评分之间是否存在相关性。我们假设（1）MS-TKA将产生内侧枢轴运动，并且（2）此特定模式将与更高的临床评分相关。

方法

通过临床和功能评分评估（膝关节社会和功能评分，Womac，牛津大学）评估患者，并在坐直立手术后9个月通过动态放射立体分析（RSA）在运动学上通过运动学评估和弓步运动任务。通过Student's t检验比较股内侧和外侧股室的前后（AP）低位平移（p  <0.05）。通过皮尔逊相关系数r进行分数和运动学之间的相关分析。

结果

 从坐到站（内侧2.9毫米±0.7毫米，外侧7.1毫米±0.6毫米）和弓箭（内侧5.3毫米）均发现外侧隔室相对于内侧的前移明显更大（p <0.0001） ±0.9毫米，外侧10.9毫米±0.7毫米）的运动任务，因此在大约70％的患者中产生了内侧枢转模式。在侧卧位AP翻译的峰值与临床评分之间发现了从坐到站的显着正相关（ 膝关节社会评分临床r = 0.59  ，牛津大学r = 0.61）。此外，我们发现内侧隔室的AP翻译高峰较高与较低的临床评分相关（ 膝关节社会评分临床评分r = − 0.55，r 对于弓箭来说，Womac = − 0.61，牛津r  = − 0.53。膝关节坐立姿势期间的膝关节社会评分临床表现和VV松弛（r  = − 0.56）与弓步运动任务中的外旋高峰（r  = − 0.66）之间呈负相关。

结论

在两次检查的运动任务中，所研究的MS-TKA在体内产生了大约70％的患者内侧枢轴运动。内侧枢纽的存在与较高的术后评分之间存在相关性。

证据水平

IV。