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Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty.
Knee Surg Sports Traumatol Arthrosc. 2016 Sep; 24(9):3036-3043.KS

Abstract

PURPOSE

There remains no consensus as to whether mobile total knee arthroplasty (TKA) should use a posterior cruciate ligament-sacrificing ultracongruent (UC) or a posterior cruciate ligament-substituting posterior stabilized (PS) prosthesis. The purpose of this study was to assess intraoperative kinematics and clinical outcomes of UC and PS rotating platform mobile-bearing TKA.

METHODS

In this randomized controlled study, mobile UC TKA prostheses (n = 45) were compared with mobile PS TKA prostheses (n = 45) with regard to intraoperative kinematics and clinical outcomes. The passive kinematic study using intraoperative navigation system included anterior/posterior translation, varus/valgus alignment and rotation of femur during flexion. The patients were clinically and radiographically evaluated over a 3-year follow-up.

RESULTS

Paradoxical anterior translation of the femur was 10.8 ± 5.2 mm in the UC knee from 0° to 82° of knee flexion and 8.7 ± 3.0 mm in the PS knee from 0° to 70° of knee flexion (p = 0.027). Paradoxical internal rotation of the femur was 5.8° in the UC knees and 9.9° in the PS knees (p = 0.003). But, there was no significant difference between the groups in regard to the coronal alignment. There was no significant difference in the range of motion, KS knee scores, KS function scores, and WOMAC index scores.

CONCLUSIONS

Despite different intraoperative kinematics between mobile UC and mobile PS TKA, neither design reproduced physiologic knee kinematics and there was no difference in clinical outcomes between the two groups. The clinical relevance of the study is that despite different intraoperative kinematics, UC design can be a considerable alternative to PS design in mobile-bearing TKA in respect of clinical outcomes.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Hallym University Hospital, Chuncheon, 77, Sakju-ro, Chuncheon-si, Gangwon-do, 200-704, Korea.Department of Orthopaedic Surgery, Seoul Jaeil Hospital, 70, Jisan-ro, Pyeongtaek-si, Gyeonggi-do, Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 464-707, Korea.Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehang-ro, Jongno-gu, Seoul, 110-744, Korea.Department of Orthopaedic Surgery, Daehan Hospital, 301, Dobong-ro, Ganbuk-gu, Seoul, 132-703, Korea.Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehang-ro, Jongno-gu, Seoul, 110-744, Korea. leemc@snu.ac.kr.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25567541

Citation

Kim, Tae Woo, et al. "Different Intraoperative Kinematics With Comparable Clinical Outcomes of Ultracongruent and Posterior Stabilized Mobile-bearing Total Knee Arthroplasty." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 24, no. 9, 2016, pp. 3036-3043.
Kim TW, Lee SM, Seong SC, et al. Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016;24(9):3036-3043.
Kim, T. W., Lee, S. M., Seong, S. C., Lee, S., Jang, J., & Lee, M. C. (2016). Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 24(9), 3036-3043. https://doi.org/10.1007/s00167-014-3489-0
Kim TW, et al. Different Intraoperative Kinematics With Comparable Clinical Outcomes of Ultracongruent and Posterior Stabilized Mobile-bearing Total Knee Arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016;24(9):3036-3043. PubMed PMID: 25567541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty. AU - Kim,Tae Woo, AU - Lee,Sang Min, AU - Seong,Sang Cheol, AU - Lee,Sahnghoon, AU - Jang,Jak, AU - Lee,Myung Chul, Y1 - 2015/01/08/ PY - 2014/04/25/received PY - 2014/12/12/accepted PY - 2015/1/9/entrez PY - 2015/1/9/pubmed PY - 2017/4/28/medline KW - Clinical outcome KW - Kinematics KW - Posterior stabilized KW - Total knee arthroplasty KW - Ultracongruent SP - 3036 EP - 3043 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 24 IS - 9 N2 - PURPOSE: There remains no consensus as to whether mobile total knee arthroplasty (TKA) should use a posterior cruciate ligament-sacrificing ultracongruent (UC) or a posterior cruciate ligament-substituting posterior stabilized (PS) prosthesis. The purpose of this study was to assess intraoperative kinematics and clinical outcomes of UC and PS rotating platform mobile-bearing TKA. METHODS: In this randomized controlled study, mobile UC TKA prostheses (n = 45) were compared with mobile PS TKA prostheses (n = 45) with regard to intraoperative kinematics and clinical outcomes. The passive kinematic study using intraoperative navigation system included anterior/posterior translation, varus/valgus alignment and rotation of femur during flexion. The patients were clinically and radiographically evaluated over a 3-year follow-up. RESULTS: Paradoxical anterior translation of the femur was 10.8 ± 5.2 mm in the UC knee from 0° to 82° of knee flexion and 8.7 ± 3.0 mm in the PS knee from 0° to 70° of knee flexion (p = 0.027). Paradoxical internal rotation of the femur was 5.8° in the UC knees and 9.9° in the PS knees (p = 0.003). But, there was no significant difference between the groups in regard to the coronal alignment. There was no significant difference in the range of motion, KS knee scores, KS function scores, and WOMAC index scores. CONCLUSIONS: Despite different intraoperative kinematics between mobile UC and mobile PS TKA, neither design reproduced physiologic knee kinematics and there was no difference in clinical outcomes between the two groups. The clinical relevance of the study is that despite different intraoperative kinematics, UC design can be a considerable alternative to PS design in mobile-bearing TKA in respect of clinical outcomes. LEVEL OF EVIDENCE: II. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/25567541/Different_intraoperative_kinematics_with_comparable_clinical_outcomes_of_ultracongruent_and_posterior_stabilized_mobile_bearing_total_knee_arthroplasty_ L2 - https://dx.doi.org/10.1007/s00167-014-3489-0 DB - PRIME DP - Unbound Medicine ER -