Abstract
Purpose
It is still controversial whether anteroposterior (AP) translation magnitude after total knee arthroplasty (TKA) affects clinical outcomes, particularly range of motion (ROM). This study examined the following two questions: (1) are AP translations at the mid- and long-term follow-up different for knees within the same patient treated with posterior cruciate ligament-retaining (PCLR) versus posterior cruciate ligament-substituting (PCLS) mobile-bearing TKA prosthesis designs? (2) Is the ROM at the mid- and long-term follow-up for knees treated with PCLR and PCLS designs correlated with the AP translation?
Methods
Thirty-seven patients undergoing sequential bilateral TKA for osteoarthritis were prospectively enrolled. Patients received a PCLR implant in one knee and a PCLS implant in the other and were followed-up for an average 9.8 ± 3.2 years. The AP translations at 30° and 75° of knee flexion and the ROM of both knees were assessed.
Results
The implant design (p < 0.001), but not flexion angle (n.s.), had a significant effect on AP translation. AP translation values were larger in PCLR knees than in PCLS knees at both flexion angles (p < 0.0001). The ROM at the final follow-up in the two implant designs was similar (both 115°, n.s.). There was a weak correlation between ROM and AP translation at 30° in the PCLR knees (r = 0.397, p = 0.015), but no correlation at 75° or in the PCLS knees.
Conclusions
Differently constrained prosthesis designs resulted in significantly different AP translational values within the same patient. This indicates that achieving good clinical outcomes and ROM after TKA may not be strongly influenced by the specifics of each patient’s anatomical characteristics, but instead by knee constrainment. Clinically, this means that surgeons should familiarize themselves with the AP translation of the implant being used, as this may be the most important factor for optimizing outcomes after mobile-bearing TKA.
Level of evidence II, prospective, comparative study.
Similar content being viewed by others
References
Alicea J (2001) Scoring systems and their validation for the arthritic knee. In: Insall JN, Scott WN (eds) Surgery of the knee, vol 2, 3rd edn. Churchill Livingstone, New York, pp 1507–1515
Chouteau J, Lerat JL, Testa R, Moyen B, Banks SA (2009) Sagittal laxity after posterior cruciate ligament-retaining mobile-bearing total knee arthroplasty. J Arthroplasty 24:710–715
Dejour D, Deschamps G, Garotta L, Dejour H (1999) Laxity in posterior cruciate sparing and posterior stabilized total knee prostheses. Clin Orthop Relat Res 364:182–193
Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint: anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231
Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2005) Sagittal laxity in vivo after total knee arthroplasty. Arch Orthop Trauma Surg 125:249–253
Ishii Y, Noguchi H, Takeda M, Sato J, Sakurai T, Toyabe S (2014) In vivo anteroposterior translation after meniscal-bearing total knee arthroplasty: effects of soft tissue conditions and flexion angle. Eur J Orthop Surg Traumatol 24:967–971
Ishii Y, Noguchi H, Takeda M, Sato J, Toyabe S (2011) Prediction of range of motion 2 years after mobile-bearing total knee arthroplasty: PCL-retaining versus PCL-sacrificing. Knee Surg Sports Traumatol Arthrosc 19:2002–2008
Ishii Y, Noguchi H, Takeda M, Sato J, Toyabe S (2014) Anteroposterior translation does not correlate with knee flexion after total knee arthroplasty. Clin Orthop Relat Res 472:704–709
Ishii Y, Noguchi H, Takeda M, Kiga H, Toyabe SI (2011) Effect of voluntary soft tissue tension and articular conformity after total knee arthroplasty on in vivo anteroposterior displacement. Knee 18:11–14
Ishii Y, Terajima K, Koga Y, Takahashi HE, Bechtold JE, Gustilo RB (1995) Comparison of knee joint functional laxity after total knee replacement with posterior cruciate-retaining and cruciate-substituting prostheses. Knee 2:195–199
Itokazu M, Masuda K, Wada E, Ohno T, Yoshida M, Takatu T (2000) Influence of anteroposterior and mediolateral instability on range of motion after total knee arthroplasty: an ultrasonographic study. Orthopedics 23:49–52
Iversen BF, Sturup J, Jacobsen K, Andersen J (1989) Implications of muscular defense in testing for the anterior drawer sign in the knee: a stress radiographic investigation. Am J Sports Med 17:409–413
Jones DP, Locke C, Pennington J, Theis JC (2006) The effect of sagittal laxity on function after posterior cruciate-retaining total knee replacement. J Arthroplasty 21:719–723
Matsuda S, Miura H, Nagamine R, Urabe K, Matsunobu T, Iwamoto Y (1999) Knee stability in posterior cruciate ligament retaining total knee arthroplasty. Clin Orthop Relat Res 366:169–173
Matsuda Y, Ishii Y (2004) In vivo laxity of low contact stress mobile-bearing prostheses. Clin Orthop Relat Res 419:138–143
Mikashima Y, Ishii Y, Takeda M, Noguchi H, Momohara S, Banks SA (2013) Do mobile-bearing knee arthroplasty motions change with activity? Knee 20:422–425
Mizu-Uchi H, Matsuda S, Miura H, Nabeyama R, Okazaki K, Iwamoto Y (2006) Anteroposterior stability in posterior cruciate ligament-retaining total knee arthroplasty. J Arthroplasty 21:592–598
Nabeyama R, Matsuda S, Miura H, Kawano T, Nagamine R, Mawatari T, Tanaka K, Iwamoto Y (2003) Changes in anteroposterior stability following total knee arthroplasty. J Orthop Sci 8:526–531
Schuster AJ, von Roll AL, Pfluger D, Wyss T (2011) Anteroposterior stability after posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19:1113–1120
Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN (2012) The new knee society knee scoring system. Clin Orthop Relat Res 470:3–19
Seah RB, Pang HN, Lo NN, Chong HC, Chin PL, Chia SL, Yeo SJ (2012) Evaluation of the relationship between anteroposterior translation of a posterior cruciate ligament-retaining total knee replacement and functional outcome. J Bone Joint Surg Br 94:1362–1365
Seon JK, Park SJ, Yoon TR, Lee KB, Moon ES, Song EK (2010) The effect of anteroposterior laxity on the range of movement and knee function following a cruciate-retaining total knee replacement. J Bone Joint Surg Br 92:1090–1095
Seon JK, Song EK, Yoon TR, Bae BH, Park SJ, Cho SG (2007) In vivo stability of total knee arthroplasty using a navigation system. Int Orthop 31:45–48
Walker PS, Ambarek MS, Morris JR, Olanlokun K, Cobb A (1995) Anterior-posterior stability in partially conforming condylar knee replacement. Clin Orthop Relat Res 310:87–97
Warren PJ, Olanlokun TK, Cobb AG, Walker PS, Iverson BF (1994) Laxity and function in knee replacements: a comparative study of three prosthetic designs. Clin Orthop Relat Res 305:200–208
White SH, O’Connor JJ, Goodfellow JW (1991) Sagittal plane laxity following knee arthroplasty. J Bone Joint Surg Br 73:268–270
Yamakado K, Kitaoka K, Yamada H, Hashiba K, Nakamura R, Tomita K (2003) Influence of stability on range of motion after cruciate-retaining TKA. Arch Orthop Trauma Surg 123:1–4
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ishii, Y., Noguchi, H., Sato, J. et al. Anteroposterior translation and range of motion after total knee arthroplasty using posterior cruciate ligament-retaining versus posterior cruciate ligament-substituting prostheses. Knee Surg Sports Traumatol Arthrosc 25, 3536–3542 (2017). https://doi.org/10.1007/s00167-016-4257-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-016-4257-0