The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry
Abstract The goal of this study was to investigate the impact of postoperative inclination of the joint line on clinical results after total knee arthroplasty (TKA) using a prosthesis with anatomical geometry. This study included 145 primary cruciate-retaining type of knee prosthesis with anatomical...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-01-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-28182-2 |
| _version_ | 1797945979725414400 |
|---|---|
| author | Manabu Yamada Arata Nakajima Masato Sonobe Yorikazu Akatsu Keiichiro Yamamoto Junya Saito Masaki Norimoto Keita Koyama Shinji Taniguchi Yasuchika Aoki Toru Suguro Koichi Nakagawa |
| author_facet | Manabu Yamada Arata Nakajima Masato Sonobe Yorikazu Akatsu Keiichiro Yamamoto Junya Saito Masaki Norimoto Keita Koyama Shinji Taniguchi Yasuchika Aoki Toru Suguro Koichi Nakagawa |
| author_sort | Manabu Yamada |
| collection | DOAJ |
| description | Abstract The goal of this study was to investigate the impact of postoperative inclination of the joint line on clinical results after total knee arthroplasty (TKA) using a prosthesis with anatomical geometry. This study included 145 primary cruciate-retaining type of knee prosthesis with anatomical geometry. Three years postoperatively, clinical outcomes including the patient-reported outcomes (PROs) were recorded. Limb alignment was evaluated by the hip-knee-ankle (HKA) axis and inclination of the joint line was assessed by the joint line orientation angle (JLOA). Knees were divided into two groups according to the HKA: in-range (− 3 to 3°) and outlier group (< − 3° or > 3°) or the JLOA: in-range (2–4°) and outlier group (< 2° or > 4°), and clinical outcomes were compared between the groups. Postoperative Knee Society Function Score (KS-FS) was significantly higher in the HKA in-range group than the outlier group (p = 0.01). The Knee Society Knee Score and all subscales of the Knee injury Osteoarthritis Outcome Score were comparable between the groups. A multivariate analysis revealed a significant association between age at operation and postoperative KS-FS > of 80 points. Neither HKA in-range nor JLOA in-range were associated with the higher knee function. In conclusion, TKA-postoperative inclination of the joint line was not relevant to the short-term PROs. Treatment strategies that attempt to make joint line inclination in order to improve postoperative PROs should be avoided, and alignment goals such as kinematic alignment should be considered carefully. |
| first_indexed | 2024-04-10T21:03:37Z |
| format | Article |
| id | doaj.art-cef4a07a25d140bbbf817ed8d28fd9e0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-10T21:03:37Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-cef4a07a25d140bbbf817ed8d28fd9e02023-01-22T12:10:39ZengNature PortfolioScientific Reports2045-23222023-01-011311910.1038/s41598-023-28182-2The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometryManabu Yamada0Arata Nakajima1Masato Sonobe2Yorikazu Akatsu3Keiichiro Yamamoto4Junya Saito5Masaki Norimoto6Keita Koyama7Shinji Taniguchi8Yasuchika Aoki9Toru Suguro10Koichi Nakagawa11Department of Orthopaedic Surgery, Toho University Graduate School of MedicineDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterDepartment of Orthopaedic Surgery, Eastern Chiba Medical CenterJapan Research Institute of Artificial JointDepartment of Orthopaedic Surgery, Toho University Sakura Medical CenterAbstract The goal of this study was to investigate the impact of postoperative inclination of the joint line on clinical results after total knee arthroplasty (TKA) using a prosthesis with anatomical geometry. This study included 145 primary cruciate-retaining type of knee prosthesis with anatomical geometry. Three years postoperatively, clinical outcomes including the patient-reported outcomes (PROs) were recorded. Limb alignment was evaluated by the hip-knee-ankle (HKA) axis and inclination of the joint line was assessed by the joint line orientation angle (JLOA). Knees were divided into two groups according to the HKA: in-range (− 3 to 3°) and outlier group (< − 3° or > 3°) or the JLOA: in-range (2–4°) and outlier group (< 2° or > 4°), and clinical outcomes were compared between the groups. Postoperative Knee Society Function Score (KS-FS) was significantly higher in the HKA in-range group than the outlier group (p = 0.01). The Knee Society Knee Score and all subscales of the Knee injury Osteoarthritis Outcome Score were comparable between the groups. A multivariate analysis revealed a significant association between age at operation and postoperative KS-FS > of 80 points. Neither HKA in-range nor JLOA in-range were associated with the higher knee function. In conclusion, TKA-postoperative inclination of the joint line was not relevant to the short-term PROs. Treatment strategies that attempt to make joint line inclination in order to improve postoperative PROs should be avoided, and alignment goals such as kinematic alignment should be considered carefully.https://doi.org/10.1038/s41598-023-28182-2 |
| spellingShingle | Manabu Yamada Arata Nakajima Masato Sonobe Yorikazu Akatsu Keiichiro Yamamoto Junya Saito Masaki Norimoto Keita Koyama Shinji Taniguchi Yasuchika Aoki Toru Suguro Koichi Nakagawa The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry Scientific Reports |
| title | The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| title_full | The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| title_fullStr | The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| title_full_unstemmed | The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| title_short | The impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| title_sort | impact of postoperative inclination of the joint line on clinical outcomes in total knee arthroplasty using a prosthesis with anatomical geometry |
| url | https://doi.org/10.1038/s41598-023-28182-2 |
| work_keys_str_mv | AT manabuyamada theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT aratanakajima theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT masatosonobe theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT yorikazuakatsu theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT keiichiroyamamoto theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT junyasaito theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT masakinorimoto theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT keitakoyama theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT shinjitaniguchi theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT yasuchikaaoki theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT torusuguro theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT koichinakagawa theimpactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT manabuyamada impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT aratanakajima impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT masatosonobe impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT yorikazuakatsu impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT keiichiroyamamoto impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT junyasaito impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT masakinorimoto impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT keitakoyama impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT shinjitaniguchi impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT yasuchikaaoki impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT torusuguro impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry AT koichinakagawa impactofpostoperativeinclinationofthejointlineonclinicaloutcomesintotalkneearthroplastyusingaprosthesiswithanatomicalgeometry |