Does knee stability in the coronal plane in extension affect function and outcome after total knee arthroplasty?

Hiroyuki Nakahara, Ken Okazaki, Satoshi Hamai, Shigetoshi Okamoto, Umito Kuwashima, Hidehiko Higaki, Yukihide Iwamoto

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: The aim of the present study was to clarify whether varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, and patient-reported outcomes after total knee arthroplasty (TKA) were correlated with each other. Methods: Ninety-four knees, which had undergone posterior-stabilized TKA, were analysed. The varus–valgus laxity during knee extension was measured using a stress radiograph. New Knee Society Score (KSS) questionnaires were mailed to all patients. Correlations between the values of stress radiographs and KSS were analysed. Additionally, continuous radiological images were taken of 15 patients while each walked on a treadmill to determine condylar lift-off from the tibial tray using a 3D-to-2D image-to-model registration technique. Correlations between the amount of lift-off and either the stress radiograph or the KSS were also analyzed. Results: The mean angle measured was 5.9 ± 2.7° with varus stress and 5.0 ± 1.6° with valgus stress. The difference between them was 0.9 ± 2.8°. Varus–valgus laxities, or the differences between them, did not show any statistically significant correlation with either component of the KSS (p > 0.05). The average amount of femoral condylar lift-off during walking was 1.4 ± 0.8 mm (medial side) and 1.3 ± 0.6 mm (lateral side). The amount of lift-off did not correlate with either varus–valgus laxities or the KSS (p > 0.05). Conclusions: No correlations were found among varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, or patient-reported outcomes after well-aligned TKA. This study suggests that small variations in coronal laxities do not influence lift-off during walking and the patient-reported outcomes. Level of evidence: IV.

Original languageEnglish
Article number3122
Pages (from-to)1693-1698
Number of pages6
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume23
Issue number6
DOIs
Publication statusPublished - Jun 26 2015

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Knee Replacement Arthroplasties
Knee
Walking
Thigh
Patient Reported Outcome Measures

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Does knee stability in the coronal plane in extension affect function and outcome after total knee arthroplasty? / Nakahara, Hiroyuki; Okazaki, Ken; Hamai, Satoshi; Okamoto, Shigetoshi; Kuwashima, Umito; Higaki, Hidehiko; Iwamoto, Yukihide.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 23, No. 6, 3122, 26.06.2015, p. 1693-1698.

Research output: Contribution to journalArticle

Nakahara, Hiroyuki ; Okazaki, Ken ; Hamai, Satoshi ; Okamoto, Shigetoshi ; Kuwashima, Umito ; Higaki, Hidehiko ; Iwamoto, Yukihide. / Does knee stability in the coronal plane in extension affect function and outcome after total knee arthroplasty?. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2015 ; Vol. 23, No. 6. pp. 1693-1698.
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abstract = "Purpose: The aim of the present study was to clarify whether varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, and patient-reported outcomes after total knee arthroplasty (TKA) were correlated with each other. Methods: Ninety-four knees, which had undergone posterior-stabilized TKA, were analysed. The varus–valgus laxity during knee extension was measured using a stress radiograph. New Knee Society Score (KSS) questionnaires were mailed to all patients. Correlations between the values of stress radiographs and KSS were analysed. Additionally, continuous radiological images were taken of 15 patients while each walked on a treadmill to determine condylar lift-off from the tibial tray using a 3D-to-2D image-to-model registration technique. Correlations between the amount of lift-off and either the stress radiograph or the KSS were also analyzed. Results: The mean angle measured was 5.9 ± 2.7° with varus stress and 5.0 ± 1.6° with valgus stress. The difference between them was 0.9 ± 2.8°. Varus–valgus laxities, or the differences between them, did not show any statistically significant correlation with either component of the KSS (p > 0.05). The average amount of femoral condylar lift-off during walking was 1.4 ± 0.8 mm (medial side) and 1.3 ± 0.6 mm (lateral side). The amount of lift-off did not correlate with either varus–valgus laxities or the KSS (p > 0.05). Conclusions: No correlations were found among varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, or patient-reported outcomes after well-aligned TKA. This study suggests that small variations in coronal laxities do not influence lift-off during walking and the patient-reported outcomes. Level of evidence: IV.",
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AU - Nakahara, Hiroyuki

AU - Okazaki, Ken

AU - Hamai, Satoshi

AU - Okamoto, Shigetoshi

AU - Kuwashima, Umito

AU - Higaki, Hidehiko

AU - Iwamoto, Yukihide

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N2 - Purpose: The aim of the present study was to clarify whether varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, and patient-reported outcomes after total knee arthroplasty (TKA) were correlated with each other. Methods: Ninety-four knees, which had undergone posterior-stabilized TKA, were analysed. The varus–valgus laxity during knee extension was measured using a stress radiograph. New Knee Society Score (KSS) questionnaires were mailed to all patients. Correlations between the values of stress radiographs and KSS were analysed. Additionally, continuous radiological images were taken of 15 patients while each walked on a treadmill to determine condylar lift-off from the tibial tray using a 3D-to-2D image-to-model registration technique. Correlations between the amount of lift-off and either the stress radiograph or the KSS were also analyzed. Results: The mean angle measured was 5.9 ± 2.7° with varus stress and 5.0 ± 1.6° with valgus stress. The difference between them was 0.9 ± 2.8°. Varus–valgus laxities, or the differences between them, did not show any statistically significant correlation with either component of the KSS (p > 0.05). The average amount of femoral condylar lift-off during walking was 1.4 ± 0.8 mm (medial side) and 1.3 ± 0.6 mm (lateral side). The amount of lift-off did not correlate with either varus–valgus laxities or the KSS (p > 0.05). Conclusions: No correlations were found among varus–valgus laxities under static stress in extension, femoral condylar lift-off during walking, or patient-reported outcomes after well-aligned TKA. This study suggests that small variations in coronal laxities do not influence lift-off during walking and the patient-reported outcomes. Level of evidence: IV.

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