Bicruciate-retaining total knee arthroplasty reproduces in vivo kinematics of normal knees to a lower extent than unicom
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KNEE
Bicruciate‑retaining total knee arthroplasty reproduces in vivo kinematics of normal knees to a lower extent than unicompartmental knee arthroplasty Kenichi Kono1 · Hiroshi Inui1 · Tetsuya Tomita2 · Takaharu Yamazaki3 · Shuji Taketomi1 · Sakae Tanaka1 Received: 10 July 2019 / Accepted: 7 October 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose This study aimed to clarify the natural knee kinematics provided by bicruciate-retaining total knee arthroplasty (BCR-TKA) compared with those of unicompartmental knee arthroplasty (UKA) and normal knees. Methods Volunteers and patients who had undergone UKA and BCR-TKA with anatomical articular surface performed squatting motion under fluoroscopy. To estimate the knee’s spatial position and orientation, a two-dimensional/three-dimensional registration technique was used. The rotation angle and anteroposterior translation of the medial and lateral sides of the femur relative to the tibia in each flexion angle were directly evaluated using the same local coordinate system and their differences amongst the three groups were analysed using two-way analysis of variance and Bonferroni post hoc pairwise comparison. Results From 0° to 10° of flexion, the femoral external rotation angle of BCR-TKA knees was significantly greater than that of normal and UKA knees and the medial side of BCR-TKA knees was significantly more anteriorly located than that of normal and UKA knees. From 40° to 50° of flexion, the medial side of UKA knees was significantly more posteriorly located than that of normal and BCR-TKA knees. From 30° to 120° of flexion, the lateral side of BCR-TKA knees was significantly more anteriorly located than that of normal and UKA knees. Conclusion The in vivo kinematics of BCR-TKA knees reproduces those of normal knees to a lower extent than those of UKA knees. Thus, BCR-TKA with anatomical articular surface reproduces in vivo kinematics of normal knees to a lower extent than UKA. Level of evidence III. Keywords Bicruciate-retaining total knee arthroplasty · Unicompartmental knee arthroplasty · Kinematics · Squatting Abbreviations KSS 2011 2011 Knee Society Score 2D Two-dimensional Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00167-019-05754-2) contains supplementary material, which is available to authorized users. * Hiroshi Inui [email protected] 1
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo 113‑0033, Japan
2
Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan
3
Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, Saitama, Japan
3D Three-dimensional ACL Anterior cruciate ligament ANOVA Analysis of variance AP Anteroposterior BCR-TKA Bicruciate-retaining total knee arthroplasty CAD Computer-aided design CR Cruciate-retaining CR-TKA Cruciate-retaining total kne
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