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Inui H, Yamagami R, Kono K, Kawaguchi K, Kage T, Murakami R, Nakamura H, Saita K, Taketomi S, Tanaka S. Short-term clinical results of bicruciate-retaining total knee arthroplasty using personalized alignment. BMC Musculoskelet Disord 2023; 24:965. [PMID: 38087214 PMCID: PMC10714564 DOI: 10.1186/s12891-023-07083-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Bicruciate-retaining (BCR) prosthesis has been introduced to recreate normal knee movement by preserving both the anterior and posterior cruciate ligaments. However, the use of BCR total knee arthroplasty (TKA) is still debatable because of several disappointing reports. We have been performing BCR TKAs with personalized alignment (PA). This study aimed to reveal the limb alignment and soft tissue balance of FA-BCR TKAs and compare the clinical outcomes of FA-BCR TKAs with those of unicompartmental knee arthroplasty (UKA). METHODS Fifty BCR TKAs and 58 UKAs were included in this study. The joint component gaps of BCR TKA were evaluated intraoperatively and the postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) were measured using full-length standing radiography. The short-term clinical outcomes of BCR TKAs were compared with those of UKA using the scoring system of 2011 Knee Society Scoring (KSS) and the knee injury and osteoarthritis outcome score (KOOS) at an average of 2 years postoperatively (1-4yeras). RESULTS The coronal alignment values of PA-BCR TKA were as follows: HKA angle, 177.9° ± 2.3°; MPTA, 85.4° ± 1.9°; and LDFA, 87.5° ± 1.9°. The joint component gaps at flexion angles of 10°, 30°, 60°, and 90° were 11.1 ± 1.2, 10.9 ± 1.4, 10.7 ± 1.3, and 11.2 ± 1.4 mm for the medial compartment and 12.9 ± 1.5, 12.6 ± 1.8, 12.5 ± 1.8 and 12.5 ± 1.7 mm for the lateral compartment, respectively. The patient expectation score and maximum extension angle of PA-BCR TKA were significantly better than those of UKAs. CONCLUSIONS The short-term clinical outcomes of PA-BCR TKA were comparable or a slightly superior to those of UKAs.
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Affiliation(s)
- Hiroshi Inui
- Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama, 350-8500, Japan.
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Ryota Yamagami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kohei Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tomofumi Kage
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ryo Murakami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Haruhiko Nakamura
- Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama, 350-8500, Japan
| | - Kazuo Saita
- Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama, 350-8500, Japan
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Yamamoto A, Kaneko T, Takada K, Yoshizawa S. The importance of selecting a cruciate-retaining total knee prosthesis for a patient with a large physiological posterior tibial slope: a case report. J Surg Case Rep 2022; 2022:rjac584. [PMID: 36570546 PMCID: PMC9769956 DOI: 10.1093/jscr/rjac584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022] Open
Abstract
For Japanese individuals, deep bending is inevitable in their daily lives, such as during seiza sitting and kneeling. Thus, achieving a good post-operative range of motion is an important factor in improving patient satisfaction. Even normal knees often have a posterior tibial slope of more than 10°. We report the case of a 76-year-old woman who underwent proximal tibial osteotomy at 8° with the Vanguard Knee cruciate retaining total knee arthroplasty (TKA) system. She required the revision TKA 10 years later due to ultra-high-molecular-weight polyethylene wear and breakage of the posteromedial tibial component.
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Affiliation(s)
- Ayakane Yamamoto
- Ichinomiya Onsen Hot Hospital, Adult Reconstruction Center, 1745 Tsuboi, Ichinomiyacho, Fuefuki-city, Yamanashi 405-0077, Japan
| | - Takao Kaneko
- Correspondence address. Ichinomiya Onsen Hot Hospital, Adult Reconstruction Center, 1745 Tsuboi, Ichinomiyacho, Fuefuki-city, Yamanashi 405-0077, Japan. Tel: +81-553-47-3131; Fax: + 81-553-47-3434; E-mail:
| | - Kazutaka Takada
- Ichinomiya Onsen Hot Hospital, Adult Reconstruction Center, 1745 Tsuboi, Ichinomiyacho, Fuefuki-city, Yamanashi 405-0077, Japan
| | - Shu Yoshizawa
- Ichinomiya Onsen Hot Hospital, Adult Reconstruction Center, 1745 Tsuboi, Ichinomiyacho, Fuefuki-city, Yamanashi 405-0077, Japan
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