The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee
Background The improvement of flexion contracture is important in knee arthroplasty since residual flexion contracture postoperatively is associated with decreased quality of life and patient satisfaction. In this study, we investigated the effect of bi-cruciate stabilized (BCS)-type total knee arth...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-10-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/10225536231190524 |
| _version_ | 1797661853379198976 |
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| author | Atsuo Inoue Yuji Arai Shuji Nakagawa Yasushi Yoshihara Masashi Kobayashi Kenji Takahashi |
| author_facet | Atsuo Inoue Yuji Arai Shuji Nakagawa Yasushi Yoshihara Masashi Kobayashi Kenji Takahashi |
| author_sort | Atsuo Inoue |
| collection | DOAJ |
| description | Background The improvement of flexion contracture is important in knee arthroplasty since residual flexion contracture postoperatively is associated with decreased quality of life and patient satisfaction. In this study, we investigated the effect of bi-cruciate stabilized (BCS)-type total knee arthroplasty (TKA) as compared to posterior stabilized (PS)-type TKA on osteoarthritic primary knees with flexion contractures. Methods 59 TKAs from January 2014 to December 2020, of which 30 were PS-type TKAs (NexGen LPS-flex Ⓡ ; 76.3 years, BMI 27.5) and 29 BCS-type TKAs (Journey II Ⓡ ; 72.5 years, BMI 28.6), were performed for knee osteoarthritis with preoperative flexion contracture of 15° or greater. Full extension was obtained intraoperatively during all TKAs. Clinical outcomes, radiological evaluations, and the amount of additional distal femoral osteotomy during TKA were evaluated in a retrospective study design. Results The range of motion improved in the both groups. Postoperative flexion contracture was significantly improved in the BCS group. Knee Society Score improved significantly in both groups, with no difference between the two groups. The amount of additional distal femoral osteotomy was 2.5 ± 1.3 mm for the PS group, and 1.8 ± 1.5 mm for the BCS group, showing a significant difference ( p = 0.04). Discussion The BCS-type TKA significantly improved preoperative flexion contracture and reduced the amount of additional distal femoral osteotomy compared to PS-type TKA. This is attributed to the anterior cam in the BCS-type TKA, which leads to a smaller amount of protrusion of the posterior femoral condyle from the posterior margin of the tibial component in the BCS-type in knee extension, as compared to the PS-type. |
| first_indexed | 2024-03-11T18:51:43Z |
| format | Article |
| id | doaj.art-7becf6b5ff284ee285f48cc759030d8f |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-03-11T18:51:43Z |
| publishDate | 2023-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-7becf6b5ff284ee285f48cc759030d8f2023-10-11T09:33:33ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902023-10-013110.1177/10225536231190524The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic kneeAtsuo InoueYuji AraiShuji NakagawaYasushi YoshiharaMasashi KobayashiKenji TakahashiBackground The improvement of flexion contracture is important in knee arthroplasty since residual flexion contracture postoperatively is associated with decreased quality of life and patient satisfaction. In this study, we investigated the effect of bi-cruciate stabilized (BCS)-type total knee arthroplasty (TKA) as compared to posterior stabilized (PS)-type TKA on osteoarthritic primary knees with flexion contractures. Methods 59 TKAs from January 2014 to December 2020, of which 30 were PS-type TKAs (NexGen LPS-flex Ⓡ ; 76.3 years, BMI 27.5) and 29 BCS-type TKAs (Journey II Ⓡ ; 72.5 years, BMI 28.6), were performed for knee osteoarthritis with preoperative flexion contracture of 15° or greater. Full extension was obtained intraoperatively during all TKAs. Clinical outcomes, radiological evaluations, and the amount of additional distal femoral osteotomy during TKA were evaluated in a retrospective study design. Results The range of motion improved in the both groups. Postoperative flexion contracture was significantly improved in the BCS group. Knee Society Score improved significantly in both groups, with no difference between the two groups. The amount of additional distal femoral osteotomy was 2.5 ± 1.3 mm for the PS group, and 1.8 ± 1.5 mm for the BCS group, showing a significant difference ( p = 0.04). Discussion The BCS-type TKA significantly improved preoperative flexion contracture and reduced the amount of additional distal femoral osteotomy compared to PS-type TKA. This is attributed to the anterior cam in the BCS-type TKA, which leads to a smaller amount of protrusion of the posterior femoral condyle from the posterior margin of the tibial component in the BCS-type in knee extension, as compared to the PS-type.https://doi.org/10.1177/10225536231190524 |
| spellingShingle | Atsuo Inoue Yuji Arai Shuji Nakagawa Yasushi Yoshihara Masashi Kobayashi Kenji Takahashi The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee Journal of Orthopaedic Surgery |
| title | The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| title_full | The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| title_fullStr | The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| title_full_unstemmed | The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| title_short | The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| title_sort | clinical results of bi cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee |
| url | https://doi.org/10.1177/10225536231190524 |
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