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Effect of posterior design changes on postoperative flexion angle in cruciate retaining mobile-bearing total knee arthroplasty

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Abstract

The Dual Bearing Knee (DBK) prosthesis is a new concept which has a mobile-bearing insert. In May 2001, the posterior femoral condyle design of the DBK was changed to become smaller and there was a posterior shift in the base of the insert dish (Hi-Flex). Between 1998 and 2004, 371 DBKs (112 Hi-Flex and 220 Standard) were performed by one surgical team. There was a significant difference in postoperative flexion angle between the Hi-Flex and Standard DBKs (117.0° and 111.3°; p = 0.001). The delta flexion angle in the Hi-Flex (−2.4°) was significantly increased compared with that in the Standard DBK (−9.6°) (p = 0.001). In the Hi-Flex DBK, the postoperative flexion angle (5.7°) and the delta flexion angle (7.2°) were significantly larger than for the Standard DBK (p < 0.001). These results suggest that the flexion is greater for a design with smaller posterior condyle prosthesis and with a posterior shift in the base of the insert dish in CR mobile-bearing TKA.

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References

  1. Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME (2003) Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Jt Surg Am 85–A:1278–1285

    Google Scholar 

  2. Lombardi AL Jr (2002) The adult knee. In: Callaghaen JJ (ed) Soft tissue balancing of the knee-flexion. Lippincott Williams &Wilkins, Philadelphia, pp 1223–1232

    Google Scholar 

  3. Parkinson R, Bhalaik V (2001) The valgus and varus knee. Curr Orthop 15:413–422

    Article  Google Scholar 

  4. Macdonald D (2001) Flexion-extension gap theory. Curr Orthop 15:423–427

    Article  Google Scholar 

  5. Figgie HE 3rd, Goldberg VM, Heiple KG, Moller HS 3rd, Gordon NH (1986) The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis. J Bone Jt Surg Am 68:1035–1040

    Google Scholar 

  6. Bellemans J, Banks S, Victor J, Vandenneucker H, Moemans A (2002) Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty. Influence of posterior condylar offset. J Bone Jt Surg Br 84:50–53

    Article  CAS  Google Scholar 

  7. Seon JK, Park SJ, Lee KB, Li G, Kozanek M, Song EK (2009) Functional comparison of total knee arthroplasty performed with and without a navigation system. Int Orthop 33:987–990

    Article  PubMed  Google Scholar 

  8. Hanusch B, Lou TN, Warriner G, Hui A, Gregg P (2009) Functional outcome of PFC Sigma fixed and rotating-platform total knee arthroplasty. A prospective randomized controlled trial. Int Orthop 34:349–354

    Article  PubMed  Google Scholar 

  9. Jung YB, Lee YS, Lee EY, Jung HJ, Nam CH (2009) Comparison of the modified subvastus and medial parapatellar approaches in total knee arthroplasty. Int Orthop 33:419–423

    Article  PubMed  Google Scholar 

  10. Anouchi YS, McShane M, Kelly F Jr., Elting J, Stiehl J (1996) Range of motion in total knee replacement. Clin Orthop Relat Res 87–92

  11. Gupta SK, Ranawat AS, Shah V, Zikria BA, Zikria JF, Ranawat CS (2006) The P.F.C. sigma RP-F TKA designed for improved performance: a matched-pair study. Orthopedics 29:S49–S52

    PubMed  Google Scholar 

  12. Ranawat AS, Gupta SK, Ranawat CS (2006) The P.F.C. sigma RP-F total knee arthroplasty: designed for improved performance. Orthopedics 29:S28–S29

    PubMed  Google Scholar 

  13. Walker PS, Yildirim G, Sussman-Fort J, Roth J, White B, Klein GR (2007) Factors affecting the impingement angle of fixed- and mobile-bearing total knee replacements: a laboratory study. J Arthroplasty 22:745–752

    Article  PubMed  Google Scholar 

  14. Watanabe T, Yamazaki T, Sugamoto K, Tomita T, Hashimoto H, Maeda D, Tamura S, Ochi T, Yoshikawa H (2004) In vivo kinematics of mobile-bearing knee arthroplasty in deep knee bending motion. J Orthop Res 22:1044–1049

    Article  PubMed  Google Scholar 

  15. Schurman DJ, Parker JN, Ornstein D (1985) Total condylar knee replacement. A study of factors influencing range of motion as late as two years after arthroplasty. J Bone Jt Surg Am 67:1006–1014

    CAS  Google Scholar 

  16. Kim YH, Kook HK, Kim JS (2001) Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop Relat Res 101–115

  17. Ryu J, Saito S, Yamamoto K, Sano S (1993) Factors influencing the postoperative range of motion in total knee arthroplasty. Bull Hosp Joint Dis 53:35–40

    CAS  Google Scholar 

  18. Barrack RL, Bertot AJ, Wolfe MW, Waldman DA, Milicic M, Myers L (2001) Patellar resurfacing in total knee arthroplasty. A prospective, randomized, double-blind study with five to seven years of follow-up. J Bone Jt Surg Am 83–A:1376–1381

    Google Scholar 

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Authors and Affiliations

  1. Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka, Japan

    Shigeyoshi Tsuji

  2. Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita-city, Osaka, 565-0871, Japan

    Tetsuya Tomita & Kazuomi Sugamoto

  3. Orthopaedic Surgery, Rinku General Medical Center, Osaka, Japan

    Hideo Hashimoto

  4. Orthopaedic Surgery, Garacia Hospital, Osaka, Japan

    Masakazu Fujii

  5. Orthopaedics, Osaka University Graduate School of Medicine, Osaka, Japan

    Hideki Yoshikawa

Authors
  1. Shigeyoshi Tsuji
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  2. Tetsuya Tomita
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  3. Hideo Hashimoto
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  4. Masakazu Fujii
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  5. Hideki Yoshikawa
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  6. Kazuomi Sugamoto
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Corresponding author

Correspondence to Tetsuya Tomita.

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Tsuji, S., Tomita, T., Hashimoto, H. et al. Effect of posterior design changes on postoperative flexion angle in cruciate retaining mobile-bearing total knee arthroplasty. International Orthopaedics (SICOT) 35, 689–695 (2011). https://doi.org/10.1007/s00264-010-1060-2

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  • DOI: https://doi.org/10.1007/s00264-010-1060-2

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