J Knee Surg 2023; 36(10): 1013-1019
DOI: 10.1055/s-0042-1748895
Original Article

The Effect of Prosthesis Type on Intraoperative Soft-Tissue Balance and Clinical Outcomes in Modified Kinematically Aligned Cruciate-Retaining Total Knee Arthroplasty

1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Naoki Nakano
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Kazunari Ishida
2   Department of Orthopedic Surgery, Kobe Kaisei Hospital, Kobe, Japan
,
Yoshinori Takashima
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Yuichi Kuroda
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Shinya Hayashi
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Tekehiko Matsushita
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Takahiro Niikura
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Hirotsugu Muratsu
3   Department of Orthopedic Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan
,
Ryosuke Kuroda
1   Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
› Author Affiliations

Abstract

Introduction Kinematically aligned total knee arthroplasty (KA-TKA) has gained interest for achieving more favorable clinical outcomes than mechanically aligned TKA. One of the advantages of KA-TKA is reported to be an easy acquisition of intraoperative soft-tissue balance without excessive medial release for varus osteoarthritis. However, we hypothesized that the prosthesis type affects intraoperative soft-tissue balance even in the KA-TKA. The present study aimed to compare intraoperative soft-tissue balance and clinical outcomes of KA-TKAs using single-radius (SR) or multiradius (MR) prostheses.

Materialsand Methods Consecutive 70 cruciate-retaining modified KA-TKAs (31 SR and 39 MR) were performed in patients with varus-type osteoarthritis using a navigation system. Intraoperative soft-tissue balance including joint component gap and varus/valgus balance was measured with femoral component placement and patellofemoral joint reduction throughout the range of motion using offset-type tensor and compared between the two groups. Two years postoperatively, the range of motion and 2011 Knee Society Scores were compared between the two groups.

Results and Conclusion Joint component gaps showed no significant differences between the two groups from 0 to 30 degrees of flexion. However, during 60 to 120 degrees of flexion, joint component gaps of SR group showed significantly larger values than those of MR group (p < 0.05). There were no significant differences in varus/valgus balance throughout the range of motion between the two groups. The postoperative clinical outcomes showed no significant differences between the two groups.

Interpretation Despite no difference in clinical outcomes, joint component gap showed different patterns due to the prosthesis type in modified KA-TKAs.



Publication History

Received: 06 September 2021

Accepted: 18 March 2022

Article published online:
11 July 2022

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