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In vivo femorotibial kinematics of medial-stabilized total knee arthroplasty correlates to post-operative clinical outcomes

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy

    Domenico Alesi, Giulio Maria Marcheggiani Muccioli, Tommaso Roberti di Sarsina, Marco Bontempi, Nicola Pizza, Raffaele Zinno, Stefano Di Paolo & Stefano Zaffagnini

  2. University of Bologna, Bologna, Italy

    Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini & Laura Bragonzoni

Authors
  1. Domenico Alesi
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  2. Giulio Maria Marcheggiani Muccioli
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  3. Tommaso Roberti di Sarsina
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  4. Marco Bontempi
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  5. Nicola Pizza
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  6. Raffaele Zinno
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  7. Stefano Di Paolo
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  8. Stefano Zaffagnini
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  9. Laura Bragonzoni
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Corresponding author

Correspondence to Giulio Maria Marcheggiani Muccioli.

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Authors declare that they have no conflict of interest.

Ethical approval

This study obtained the approval from IRB of the IRCCS Rizzoli Orthopaedic Institute (ID: 003603 February 16th, 2016).

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Alesi, D., Marcheggiani Muccioli, G., Roberti di Sarsina, T. et al. In vivo femorotibial kinematics of medial-stabilized total knee arthroplasty correlates to post-operative clinical outcomes. Knee Surg Sports Traumatol Arthrosc 29, 491–497 (2021). https://doi.org/10.1007/s00167-020-05975-w

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