Total knee arthroplasty in-vivo kinematics changes after insert replacement for posterior cruciate ligament deficiency: a case report

Total knee arthroplasty in-vivo kinematics changes after insert replacement for posterior cruciate ligament deficiency: a case report

Authors

  • Valerio Daffara a:1:{s:5:"en_US";s:49:"Università degli Studi di Modena e Reggio Emilia";} https://orcid.org/0000-0002-2060-1722
  • Francesco Zambianchi Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia https://orcid.org/0000-0002-7634-5692
  • Tania Gualandris Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia
  • Stefano Seracchioli Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia
  • Andrea Marcovigi Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia
  • Fabio Catani Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia

Keywords:

posterior cruciate ligament, Kinematic, Total knee arthroplasty, fluoroscopy, cruciate-retaining, cruciate-substituting

Abstract

In cruciate-retaining (CR) total knee arthroplasty (TKA) the preservation of the posterior cruciate ligament (PCL) provides joint stability and drives knee kinematics. No previous studies described in-vivo knee kinematics of PCL-deficient CR TKA. In the present case report it’s described the in-vivo kinematic pattern change in a patient with post-operative PCL failure before and after insert replacement to a cruciate substituting (CS) design. In-vivo fluoroscopic analysis showed that PCL-deficient TKA showed more anterior translation of the lateral femoral condyle with respect to a cohort  of patients operated of CR-TKA with intact PCL, undergoing fluoroscopic analysis. The replacement to a CS design provided more external rotation of the femoral component and less anterior motion of the lateral condyle. The antero-posterior translation of the medial condyle was similar in PCL-deficient knee, CS TKA and controls. TKA with PCL deficiency showed more antero-posterior motion compared to TKAs with intact PCL and this can be source the of instability and a potential factor for patient’s dissatisfaction. For this reason surgeons should attentively verify PCL integrity when performing a cruciate-sparing TKA.

Author Biographies

Valerio Daffara, a:1:{s:5:"en_US";s:49:"Università degli Studi di Modena e Reggio Emilia";}

Resident Physician in Orthopedics and Traumatology

University of Modena and Reggio Emilia 

Azienda Ospedaliero Universitaria di Modena

 

Fabio Catani, Azienda Ospedaliero Universitaria di Modena - Università degli Studi di Modena e Reggio Emilia

Chief of Orthopedic Surgery Department

Chief of Master in Hand Surgery

Vice President European Knee Society

University of Modena and Reggio Emilia

Azienda Ospedaliero Universitaria di Modena

References

Eckhoff DG, Dwyer TF, Bach JM, Spitzer VM, Reinig KD. Three-dimensional morphology of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am. 2001;83-A Suppl 2(Pt 1):43-50

Banks SA, Harman MK, Bellemans J, Hodge WA. Making sense of knee arthroplasty kinematics: News you can use. J Bone Joint Surg Am. 2003;85-A Suppl 4:64-72.

Banks SA, Hodge WA. Accurate measurement of three-dimensional knee replacement kinematics using single-plane fluoroscopy. IEEE Trans Biomed Eng. 1996 Jun;43(6):638-49.

Conditt MA, Noble PC, Bertolusso R, Woody J, Parsley BS. The PCL significantly affects the functional outcome of total knee arthroplasty. J Arthroplasty. 2004 Oct;19(7 Suppl 2):107-12.

Rodriguez-Merchan EC. Instability Following Total Knee Arthroplasty. HSS J. 2011 Oct;7(3):273-8. doi: 10.1007/s11420-011-9217-0.

Catani F, Belvedere C, Ensini A, Feliciangeli A, Giannini S, Leardini A. In-Vivo knee kinematics in rotationally unconstrained total knee arthroplasty. J Orthop Res. 2011 Oct;29(10):1484-90.

Stiehl JB, Komistek RD, Dennis DA, Paxson RD, Hoff WA. Fluroscopic analysis of kinematics after posterior-cruciate-retaining knee arthroplasty. J Bone Joint Surg Br. 1995 Nov;77(6):884-9.

Banks SA, Markovich GD, Hodge WA. In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties. J Arthroplasty. 1997 Apr;12(3):297-304.

Bertin KC, Komistek RD, Dennis DA, Hoff WA, Anderson DT, Langer T. In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate-retaining total knee arthroplasty. J Arthroplasty. 2002 Dec;17(8):1040-8.

Kitagawa A, Tsumura N, Chin T, Gamada K, Banks SA, Kurosaka M. In vivo comparison of knee kinematics before and after high-flexion posterior cruciate-retaining total knee arthroplasty. J Arthroplasty. 2010 Sep;25(6):964-9.

Horiuchi H, Akizuki S, Tomita T, Sugamoto K, Yamazaki T, Shimizu N. In Vivo Kinematic Analysis of Cruciate-Retaining Total Knee Arthroplasty During Weight-Bearing and Non-Weight-Bearing Deep Knee Bending. J Arthroplasty. 2012 Jun;27(6):1196-202.

Victor J, Banks S, Bellemans J. Kinematics of posterior cruciate ligament-retaining and -substituting total knee arthroplasty. A prospective randomised outcome study. J Bone Joint Surg Br. 2005 May;87(5):646-55.

Okamoto N, Breslauer L, Hedley AK, Mizuta H, Banks SA. In Vivo Knee Kinematics in Patients With Bilateral Total Knee Arthroplasty of 2 Designs. J Arthroplasty. 2011 Sep;26(6):914-8.

Moro-Oka TA, Hamai S, Miura H et al. Dynamic activity dependence of in vivo normal knee kinematics. J Orthop Res. 2008 Apr;26(4):428-34.

Watanabe T, Ishizuki M, Muneta T, Banks SA. Knee Kinematics in Anterior Cruciate Ligament-Substituting Arthroplasty With or Without the Posterior Cruciate Ligament. J Arthroplasty. 2013 Apr;28(4):548-52.

Tei K, Matsumoto T, Shibanuma N, Kurosaka M, Kuroda R. In Vivo Kinematic Analyses of Three Different Designs of Polyethylene Inserts During Total Knee Arthroplasty (TKA) - Cruciate-Substituting (CS) Polyethylene Insert May Function as Expected. Orthopaedic Proceedings. 2013 Dec;95-B(SUPP_34):556.

Downloads

Published

05-06-2023

How to Cite

1.
Daffara V, Zambianchi F, Gualandris T, Seracchioli S, Marcovigi A, Catani F. Total knee arthroplasty in-vivo kinematics changes after insert replacement for posterior cruciate ligament deficiency: a case report. Acta Biomed [Internet]. 2023 Jun. 5 [cited 2024 Jul. 13];94(S1):e2023134. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/14338