Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature
Abstract Background Total knee arthroplasty (TKA) is one of the most performed orthopedic procedures worldwide. While excellent efficacy has been reported, about 20% of patients are not satisfied with the result. A potential cause is the problematic reproduction of knee kinematics. This systematic r...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Arthroplasty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42836-023-00165-8 |
| _version_ | 1797865537929216000 |
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| author | Salvatore Risitano Giorgio Cacciola Marcello Capella Francesco Bosco Fortunato Giustra Federico Fusini Pier Francesco Indelli Alessandro Massé Luigi Sabatini |
| author_facet | Salvatore Risitano Giorgio Cacciola Marcello Capella Francesco Bosco Fortunato Giustra Federico Fusini Pier Francesco Indelli Alessandro Massé Luigi Sabatini |
| author_sort | Salvatore Risitano |
| collection | DOAJ |
| description | Abstract Background Total knee arthroplasty (TKA) is one of the most performed orthopedic procedures worldwide. While excellent efficacy has been reported, about 20% of patients are not satisfied with the result. A potential cause is the problematic reproduction of knee kinematics. This systematic review examines gait analysis studies in primary medial pivot (MP) and posterior stabilized (PS) TKAs to investigate the differences between the two prosthesis designs. Methods A systematic review was conducted by following PRISMA guidelines. Five databases (PubMed, Medline, Embase, Scopus and the Cochrane Database of Systematic Reviews) were analyzed, and eligible articles were evaluated in terms of the levels of evidence. The methodological quality of the articles was assessed by using the MINORS scoring. This review was registered in PROSPERO. Results Nine studies were included. Gait analysis was performed in 197 MP TKA and 192 PS TKA patients. PS TKA cases showed (P < 0.05) a significantly higher peak of knee flexion angle during the swing phase, greater knee flexion angle at toe-off, an increased knee adduction angle, higher knee flexion and extension moment, increased anterior femoral roll during knee flexion and anterior translation on medial and lateral condyle during knee flexion compared to MP TKA. MP TKA showed statistically significant (P < 0.05) higher knee rotational moment and greater tibiofemoral external rotation motion during knee flexion than PS TKA. No statistically significant difference (P > 0.05) was reported regarding gait spatial–temporal parameters. The Forgotten Joint Score (FJS) and Western Ontario and McMaster Universities Comparison in terms of Arthritis Index (WOMAC) score (mean stiffness) showed that MP TKA yielded significantly better results than PS TKA. Conclusions This systematic review revealed significant kinematic and kinetic differences between MP and PS TKA at all gait analysis phases. Furthermore, the considerable difference between TKA design and the kinematics of healthy knee were highlighted in this study. Level of evidence III. |
| first_indexed | 2024-04-09T23:10:47Z |
| format | Article |
| id | doaj.art-6b1be7579c674861b21107debb721118 |
| institution | Directory Open Access Journal |
| issn | 2524-7948 |
| language | English |
| last_indexed | 2024-04-09T23:10:47Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthroplasty |
| spelling | doaj.art-6b1be7579c674861b21107debb7211182023-03-22T10:25:20ZengBMCArthroplasty2524-79482023-03-015111110.1186/s42836-023-00165-8Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literatureSalvatore Risitano0Giorgio Cacciola1Marcello Capella2Francesco Bosco3Fortunato Giustra4Federico Fusini5Pier Francesco Indelli6Alessandro Massé7Luigi Sabatini8Department of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery, Regina Montis Regalis HospitalDepartment of Orthopaedic Surgery and Bioengineering, Stanford University School of Medicine, Palo Alto Veterans Affairs Health Care System (PAVAHCS)Department of Orthopaedic Surgery and Traumatology, University of TurinDepartment of Orthopaedic Surgery and Traumatology, University of TurinAbstract Background Total knee arthroplasty (TKA) is one of the most performed orthopedic procedures worldwide. While excellent efficacy has been reported, about 20% of patients are not satisfied with the result. A potential cause is the problematic reproduction of knee kinematics. This systematic review examines gait analysis studies in primary medial pivot (MP) and posterior stabilized (PS) TKAs to investigate the differences between the two prosthesis designs. Methods A systematic review was conducted by following PRISMA guidelines. Five databases (PubMed, Medline, Embase, Scopus and the Cochrane Database of Systematic Reviews) were analyzed, and eligible articles were evaluated in terms of the levels of evidence. The methodological quality of the articles was assessed by using the MINORS scoring. This review was registered in PROSPERO. Results Nine studies were included. Gait analysis was performed in 197 MP TKA and 192 PS TKA patients. PS TKA cases showed (P < 0.05) a significantly higher peak of knee flexion angle during the swing phase, greater knee flexion angle at toe-off, an increased knee adduction angle, higher knee flexion and extension moment, increased anterior femoral roll during knee flexion and anterior translation on medial and lateral condyle during knee flexion compared to MP TKA. MP TKA showed statistically significant (P < 0.05) higher knee rotational moment and greater tibiofemoral external rotation motion during knee flexion than PS TKA. No statistically significant difference (P > 0.05) was reported regarding gait spatial–temporal parameters. The Forgotten Joint Score (FJS) and Western Ontario and McMaster Universities Comparison in terms of Arthritis Index (WOMAC) score (mean stiffness) showed that MP TKA yielded significantly better results than PS TKA. Conclusions This systematic review revealed significant kinematic and kinetic differences between MP and PS TKA at all gait analysis phases. Furthermore, the considerable difference between TKA design and the kinematics of healthy knee were highlighted in this study. Level of evidence III.https://doi.org/10.1186/s42836-023-00165-8Total knee replacementPosterior stabilisedMedial pivotKinematicsWalkingGait analysis |
| spellingShingle | Salvatore Risitano Giorgio Cacciola Marcello Capella Francesco Bosco Fortunato Giustra Federico Fusini Pier Francesco Indelli Alessandro Massé Luigi Sabatini Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature Arthroplasty Total knee replacement Posterior stabilised Medial pivot Kinematics Walking Gait analysis |
| title | Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature |
| title_full | Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature |
| title_fullStr | Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature |
| title_full_unstemmed | Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature |
| title_short | Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature |
| title_sort | comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty a systematic review of the literature |
| topic | Total knee replacement Posterior stabilised Medial pivot Kinematics Walking Gait analysis |
| url | https://doi.org/10.1186/s42836-023-00165-8 |
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