Knee joint laxity is restored in a bi-cruciate retaining TKA-design
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KNEE
Knee joint laxity is restored in a bi‑cruciate retaining TKA‑design N. Arnout1,2 · J. Victor1,2 · H. Vermue1,2 · L. Pringels1,2 · J. Bellemans3 · M. A. Verstraete2 Received: 19 November 2018 / Revised: 10 July 2019 / Accepted: 19 July 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose The goal is to evaluate the passive stability of a bicruciate retaining, cruciate retaining and bicruciate substituting TKA design in relation to the native knee stability in terms of the laxity envelope. A bicruciate retaining knee prosthesis was hypothesized to offer a closer to normal knee stability in vitro. Methods Fourteen cadaveric knee specimens have been tested under passive conditions with and without external loads, involving a varus/valgus and an external/internal rotational torque, distraction/compression force and an anteroposterior shear force. Subsequently, the native knee, bicruciate retaining, cruciate retaining and finally a bicruciate substituting total knee arthroplasty were tested. Results Through the range of motion, the width of the varus/valgus and internal/external laxity envelope for the native knee and the bicruciate retaining knee were almost equivalent, whereas the cruciate retaining and the bicruciate substituting knee displayed less laxity and more joint distraction. In all prosthetic knees, an equal anteroposterior laxity was seen for the lateral and medial side whereas in the native knee, a difference in laxity was seen between the stable medial side and the more mobile lateral side. Conclusion Bicruciate retaining knee prostheses can restore normal laxity and thus have the potential to offer more normal knee function. Restoration of natural peri-articular soft-tissue tension is clinically important because of its obvious effects on joint stability and range of motion. Furthermore, the results of this study could help to establish the ideal ligament tension and laxity in more conventional implants by approaching the normal values for passive knee evaluation as presented here. Keywords Cruciate ligaments · Total knee arthroplasty · Knee laxity
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00167-019-05639-4) contains supplementary material, which is available to authorized users. * N. Arnout [email protected]
Modern total knee designs with resection of one or both cruciate ligaments offer good long-term results in terms of survival and clinical outcome [4, 5, 16, 21]. Nevertheless, continuous efforts have to be made to meet patients’ expectations and increase patient-reported satisfaction with TKA M. A. Verstraete [email protected]
J. Victor [email protected]
1
University Hospital Ghent, Corneel Heymanslaan 10, 9000 Gent, Belgium
H. Vermue [email protected]
2
Ghent University, Gent, Belgium
3
ZOL, Schiepse Bos 6, 3600 Genk, Belgium
L. Pringels [email protected] J. Bellemans [email protected]
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