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Changes in the rotational axes of the tibiofemoral joint caused by resection of the anterior cruciate ligament.
J Orthop Res. 2017 04; 35(4):886-893.JO

Abstract

Kinematic alignment is a method of aligning implants in total knee arthroplasty (TKA) that strives to restore the native flexion-extension (F-E) and longitudinal rotation (LR) axes of the tibiofemoral joint. The anterior cruciate ligament (ACL) is typically resected at the time of TKA, which might change the position, and orientation of these axes from that of the native knee. Our objective was to determine whether resecting the ACL causes changes in the F-E and LR axes. A custom designed and validated instrumented spatial linkage (ISL) measured the F-E and LR axes in nine cadaveric knees before and after ACL resection. Changes in these axes were computed for knee flexion from 0° to 120°. For the F-E axis, the two statistically significant yet relatively small changes were internal rotation of 0.5° (p = 0.02) and posterior translation of 0.3 mm (p = 0.04). For the LR axis, the statistically significant and relatively large change was medial translation of 2.1 mm (p = 0.01). Changes to the LR axis in both medial-lateral position and varus-valgus orientation varied widely; 77% of a population of knees would have a medial-lateral position change greater than 1 mm, and 53% of a population of knees would have a varus-valgus orientation change greater than 1°. Knowledge of changes of the F-E and LR axes caused by resecting the ACL provides an important baseline for determining the changes in these axes caused by kinematic alignment and mechanical alignment of bi-cruciate retaining, posterior cruciate retaining, and posterior cruciate substituting implants. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:886-893, 2017.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Bonny DP
Biomedical Engineering Graduate Group, University of California, Davis One Shields Aveue, Davis, 95616-5270, California.
Howell SM
Biomedical Engineering Graduate Group, University of California, Davis One Shields Aveue, Davis, 95616-5270, California. Department of Mechanical Engineering, University of California, Davis One Shields Aveue, Davis, 95616-5270, California.
Hull ML
Biomedical Engineering Graduate Group, University of California, Davis One Shields Aveue, Davis, 95616-5270, California. Department of Mechanical Engineering, University of California, Davis One Shields Aveue, Davis, 95616-5270, California. Department of Biomedical Engineering, University of California, Davis One Shields Aveue, Davis, 95616-5270, California.

MeSH

AgedAged, 80 and overAnterior Cruciate LigamentArthroplasty, Replacement, KneeBiomechanical PhenomenaCadaverFemaleFemurHumansKneeKnee InjuriesKnee JointMaleRange of Motion, ArticularRotationTibia

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

27219459

Citation

Bonny, Daniel P., et al. "Changes in the Rotational Axes of the Tibiofemoral Joint Caused By Resection of the Anterior Cruciate Ligament." Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society, vol. 35, no. 4, 2017, pp. 886-893.
Bonny DP, Howell SM, Hull ML. Changes in the rotational axes of the tibiofemoral joint caused by resection of the anterior cruciate ligament. J Orthop Res. 2017;35(4):886-893.
Bonny, D. P., Howell, S. M., & Hull, M. L. (2017). Changes in the rotational axes of the tibiofemoral joint caused by resection of the anterior cruciate ligament. Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society, 35(4), 886-893. https://doi.org/10.1002/jor.23308
Bonny DP, Howell SM, Hull ML. Changes in the Rotational Axes of the Tibiofemoral Joint Caused By Resection of the Anterior Cruciate Ligament. J Orthop Res. 2017;35(4):886-893. PubMed PMID: 27219459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in the rotational axes of the tibiofemoral joint caused by resection of the anterior cruciate ligament. AU - Bonny,Daniel P, AU - Howell,Stephen M, AU - Hull,Maury L, Y1 - 2016/06/20/ PY - 2015/11/30/received PY - 2016/04/12/accepted PY - 2016/5/25/pubmed PY - 2017/5/10/medline PY - 2016/5/25/entrez KW - axis of rotation KW - kinematic alignment KW - knee joint KW - total knee arthroplasty SP - 886 EP - 893 JF - Journal of orthopaedic research : official publication of the Orthopaedic Research Society JO - J Orthop Res VL - 35 IS - 4 N2 - Kinematic alignment is a method of aligning implants in total knee arthroplasty (TKA) that strives to restore the native flexion-extension (F-E) and longitudinal rotation (LR) axes of the tibiofemoral joint. The anterior cruciate ligament (ACL) is typically resected at the time of TKA, which might change the position, and orientation of these axes from that of the native knee. Our objective was to determine whether resecting the ACL causes changes in the F-E and LR axes. A custom designed and validated instrumented spatial linkage (ISL) measured the F-E and LR axes in nine cadaveric knees before and after ACL resection. Changes in these axes were computed for knee flexion from 0° to 120°. For the F-E axis, the two statistically significant yet relatively small changes were internal rotation of 0.5° (p = 0.02) and posterior translation of 0.3 mm (p = 0.04). For the LR axis, the statistically significant and relatively large change was medial translation of 2.1 mm (p = 0.01). Changes to the LR axis in both medial-lateral position and varus-valgus orientation varied widely; 77% of a population of knees would have a medial-lateral position change greater than 1 mm, and 53% of a population of knees would have a varus-valgus orientation change greater than 1°. Knowledge of changes of the F-E and LR axes caused by resecting the ACL provides an important baseline for determining the changes in these axes caused by kinematic alignment and mechanical alignment of bi-cruciate retaining, posterior cruciate retaining, and posterior cruciate substituting implants. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:886-893, 2017. SN - 1554-527X UR - https://www.unboundmedicine.com/medline/citation/27219459/Changes_in_the_rotational_axes_of_the_tibiofemoral_joint_caused_by_resection_of_the_anterior_cruciate_ligament_ DB - PRIME DP - Unbound Medicine ER -